瑞芬太尼合并丙泊酚全麻与氯胺酮用于剖宫产全麻比较

目的探讨瑞芬太尼作为一种短效阿片类药物复合丙泊酚应用于剖宫产全麻对于产妇和新生儿的安全性和有效性,以及与氯胺酮应用于剖宫产全麻对于产妇及新生儿影响的比较。方法选择ASAⅠ～Ⅱ级,孕37～41周择期剖宫产产妇50例随机分为两组：A组（n=25）：采用丙泊酚1～1.5mg/kg,瑞芬太尼1ug/kg（静脉缓推1～2min注射完）,司可林1～2mg/kg全麻诱导;B组（n=25）：采用氯胺酮1～2mg/kg,司可林1～2mg/kg全麻诱导。记录两组产妇诱导前（T0）、气管插管后（T1）、胎儿娩出时（T2）、手术结束时（T3）的血压,心率;记录两组新生儿1、5min的Apgar评分及新生儿娩出时脐动脉血气分析。结果 A组产妇血流动力学较B组更为稳定,差异有统计学意义（P〈0.05）。两组新生儿Apgar评分及脐动脉血气分析经比较,差异无统计学意义（P〉0.05）。结论瑞芬太尼复合丙泊酚剖宫产全麻对产妇及新生儿安全有效,且较氯胺酮全麻能更好的维持产妇的血流动力学稳定。

Comparison of Remifentanil combined with propofol anesthesia for cesarean section anesthesia with ketamine

Objective To study the remifentanil as a short-acting opioids and propofol used in cesarean section anesthesia for maternal and neonatal safety and effectiveness, as well as used in cesarean section anesthesia with ketamine Comparison of maternal and neonatal effects. Methods Select ASA Ⅰ～Ⅱ grade, 50 cases of pregnant 37 to 41 weeks for elective cesarean section were randomly divided into two groups： group A（n=25）： using propofol 1 - 1.5 mg/kg, remifentanil lug / kg （slow intravenous push 1-2 min injection end）, succinylcholine 1 -2 mg/kg anesthesia induction; B group（n=25）： 1-2 mg/kg with ketamine, succinylcholine 1 -2 mg/kg anesthesia induction. Before the induction （T0）, after tracheal intubation （T1） The baby is delivered （T2）, end of surgery （T3） maternal blood pressure, heart rate of the two groups were recorded ; Record Neonatal lmin, 5min Apgar scores and neonatal umbilical arterial blood gas analysis was delivered. Results A group of maternal hemodynamic more stable than in group B, the difference was statistically significant （P〈0.05）. Neonatal Apgar scores and umbilical arterial blood gas analysis was no significant difference was not statistically significant （P〉0.05）. Conclusion Remifentanil and propofol cesarean section anesthesia on maternal and newborn safe and effective, and less ketamine anesthesia better able to maintain the maternal hemodynamic stability.