三种不同的区域麻醉方法用于妊高征剖宫产术的对比研究

目的探讨三种不同的区域麻醉方法在妊高征部宫产术中的麻醉效能及其安全性。方法选择行择期剖宫产术的ASAⅡ-Ⅲ级妊高征患者60例，分成3组，分别进行连续硬膜外麻醉、腰麻和腰-硬联合麻醉，以上局麻药采用临床常有药物。围术期连续监测呼吸和循环情况，记录麻醉效能。结果3组产妇的麻醉效能略有不同，C组麻醉平面最高（P〈0．01），所需时间最短（P〈0．01）；在术中镇痛、肌松及内脏牵拉反应方面，A组效果较差（P〈0．05）；循环变化C组波动幅度小，C组波动最明显（P〈0．05）；术中安全相关指标表明C组安全性差（P〈0．05）。结论腰硬联合麻醉妊高征剖宫产术中循环的安全性较高，但又不失良好的麻醉效能．术后可保留导管镇痛。

Three Different Regional Anesthesia Used for Cesarean Performed on Patients with Pregnancy-induced Hypertension

Objective To observe the efficacy and safety of three different regional anesthesia for cesarean performed on patients with pregnancy-induced hypertension. Methods 60 ASA Ⅱ-Ⅲ patients with pregnancy-induced hypertension who underwent cesarean were random ly divided into 3 groups： Group A（continuous epidural anesthesia, CEA ）; Group B（combined subarachnoid epidural anesthesia, CSEA） and Group C（spinal anesthesia, SA）. Common local anesthetics were used. The sensory and motor block effects, vital signs and adverse reaction such as nausea and vomiting were recorded. Results The anesthesia efficacy were diffirent in three groups： the highest level of anesthesia was hightest （P 〈 0.01） and the onset time of sensory block was shortest（P 〈 0.01） in group C; quality of analgesia and abdominal wall relaxation were better in CSEA and SA group than those in CEA group （P 〈 0.01）; The hemodynamic changes and other parameter concerned with safety were waved obviously in groups C （P 〈 0.05）. Conclusion For cesarean performed on patients with pregnancy-induced hypertension, CEA is safer while CSEA is more effective. If combined with comprehensive measures to prevent complications, CSEA is applicable in patients with pregnancy-induced hypertension.