七氟醚辅助硬膜外阻滞对剖宫产安全性的分析

目的 探讨低浓度七氟醚密闭吸入辅助硬膜外阻滞对剖宫产新生儿的安全性影响.方法 选取2013年7月至2015年4月在金华市中心医院择期行剖宫产的产妇96例.将96产妇随机分为两组,两组均采用硬膜外阻滞麻醉,观察组在切皮前使患者吸入1.5%~2.5%的七氟醚,对照组不采取任何辅助措施,对比两组产妇和新生儿的生命体征变化.结果 对照组吸入纯氧后心率(HR)、收缩压(SBP)、呼吸频率(F)水平发生显著改变,均有统计学意义(F值分别为3.189、3.081、3.103,均P<0.05);观察组吸气5min后及吸气10min后的HR、SBP、F水平显著低于对照组,均有统计学意义(t值分别为2.120、2.224、2.151、0.017、2.543、2.509,均P<0.05).观察组分娩时间显著低于对照组,有统计学意义(t=4.643,P<0.05);两组新生儿HR、pH值、酸中毒分布对比均无统计学意义(均P>0.05).两组新生儿出生后Apgar评分、血氧饱和度(SpO2)水平均无显著改变,均统计学意义(均P>0.05);两组间Apgar评分、SpO2水平对比均无统计学意义(均P>0.05).结论 低浓度七氟醚辅助剖宫产硬膜外阻滞麻醉,能缩短胎儿剖出时间,且对新生儿安全性无明显影响.

Safety of sevoflurane assisted epidural block for cesarean section

Objective To investigate the influence of low concentration sevoflurane closed inhalation assisted epidural block on safety of newborn delivered by cesarean section .Methods Altogether 96 parturients undergoing selective cesarean section in Jinhua Central Hospital from July 2013 to April 2015 were selected and randomly divided into two groups .Epidural block anesthesia was used in two groups . Patients in observation group inhaled 1.5 -2.5% sevoflurane before skin incision , while patients in control group did not take any supplementary measures .Vital signs of mothers and neonates were compared between two groups .Results Heart rate ( HR) , systolic blood pressure (SBP), respiratory rate (F) levels of patients in the control group had significant changes after inhalation of pure oxygen , and the differences were statistically significant (F value was 3.189, 3.081 and 3.103, respectively, all P<0.05).HR, SBP and F in the observation group at 5 minutes and 10 minutes after oxygen inhalation were significantly lower than those in the control group with statistical differences (t value was 2.120, 2.224, 2.151, 0.017, 2.543 and 2.509, respectively, all P<0.05).Delivery time of patients in the observation group was significantly lower than that in the control group , and difference was statistically significant (t=4.643, P<0.05). Differences in HR, pH value and acid poisoning distribution of neonates between two groups were not significant (all P>0.05).There was no significant change in Apgar score and blood oxygen saturation ( SpO2 ) of neonates in two groups after birth .There was no significant difference between two groups in Apgar score and SpO 2 level (both P>0.05).Conclusion Low concentration sevoflurane assisted epidural block anesthesia for cesarean section can shorten fetal dissection time with no significant influence on neonatal safety .