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剖腹产采用腰硬联合与硬膜外麻醉术后镇痛效果比较研究
引用本文:樊梅,程斌,欧英余.剖腹产采用腰硬联合与硬膜外麻醉术后镇痛效果比较研究[J].海南医学院学报,2013,19(5).
作者姓名:樊梅  程斌  欧英余
作者单位:成都市妇女儿童中心医院麻醉科,四川成都,610091
基金项目:中国高校医学期刊临床专项资金项目
摘    要:目的:探讨剖腹产采用腰硬联合与硬膜外麻醉术后镇痛效果有何不同,是否存在麻醉方式不同镇痛效果不同。方法:选取拟行剖腹产的产妇100例,随机分为硬膜外组(采取硬膜外麻醉)及腰硬联合组(采取腰硬联合麻醉)各50例,比较麻醉效果及术后镇痛效果。结果:硬膜外组感觉阻滞时间长于腰硬联合组,Bromage评分低于腰硬联合组,麻醉效果不及腰硬联合组,术后加用镇痛药物患者明显多于腰硬联合组,两组在感觉阻滞时间、Bromage评分、麻醉效果及术后加用镇痛药物方面比较差异具有统计学意义(P<0.05),胎儿娩出时间及手术时间两组比较差异无统计学意义(P>0.05);硬膜外组在术后6h、12h静止状态及咳嗽状态下VAS评分均高于腰硬联合组,两组比较差异具有统计学意义(P<0.05),两组均以术后12hVAS评分最高;术后眩晕发生率硬膜外组为16.00%低于腰硬联合组4.00%,比较差异具有统计学意义(P<0.05)。结论:剖腹产手术使用腰硬联合比较硬膜外麻醉效果好,术后镇痛效果优于硬膜外麻醉,但应注意麻醉并发症的发生。

关 键 词:腰硬联合  硬膜外麻醉  剖腹产  术后镇痛

Postoperative analgesia effects comparison of combined spinal-epidural anesthesia and epidural anesthesia for caesarean section
Abstract:Objective:To compare postoperative analgesia effects of combined spinal-epidural anesthesia and epidural anesthesia for caesarean section.Methods:Select 100 women scheduled for caesarean section and randomly divided into epidural anesthesia group and combined spinal-epidural anesthesia group,with 50 cases in each group.Analgesia effects of the two groups were compared.Results:Epidural anesthesia group experienced longer duration of sensory block,showed lower Bromage score than the combined spinal-epidural anesthesia group,and the combined spinal-epidural anesthesia group showed better anesthesia effects,consumed less pain killer drugs(P all <0.05).There's no significant difference in childbirth time or operation time,but VAS of the epidural anesthesia group was significant higher than that of the combined spinal-epidural anesthesia group 6 and 12 hours after the operation(P<0.05).Both groups showed the highest VAS 12 hours after the operation.Incidence of the vertigo of the epidural anesthesia group was 16.00%,significant lower than the 4.00% of the control group.Conclusion:Combined spinal-epidural anesthesia epidural anesthesia shows better postoperative analgesia effects than epidural anesthesia for caesarean operation,but attention should be paid to prevent anesthesia complications.
Keywords:Combined spinal-epidural anesthesia  Epidural anesthesia  Caesarean birth  Postoperative analgesia
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