剖宫产术中腰硬联合麻醉与硬膜外麻醉的对比研究

目的 比较腰硬联合麻醉(CSEA)和硬膜外麻醉(CEA)应用于剖宫产的临床疗效及安全性.方法 将40例行剖宫产患者,随机分为腰硬联合麻醉组(CSEA组)和硬膜外麻醉组(CEA组).分别监测两组麻醉诱导时间、补追加麻药用量及麻醉效果评价,记录新生儿第1、5分钟的Apgar评分及低血压的发生率和恶心、呕吐、头痛等不良反应的发生情况.结果 CSEA组与CEA组的一般状况无差异,CSEA组较CEA组麻醉诱导时间明显缩短(P<0.05),补追加麻药量减少(P<0.05),麻醉效果好(P<0.05).两组新生儿第1、5分钟的Apgar评分及低血压的发生率和恶心、呕吐、头痛等不良反应的发生率差异无统计学意义(P>0.05).结论 剖宫产手术中,腰硬联合麻醉较硬膜外麻醉麻醉诱导时间短,麻醉效果确切,对新生儿的影响及并发症无明显差异.

Comparative study of combined spinal-epidural snesthesia and combined epidural anesthesia in cesarean section

Objective To comparative study the clinical effect and safety of combined spinal-epidural snesthesia and combined epidural anesthesia in cesarean section. Methods 40 cases of patients were randomly divided into combined spinal-epidural anesthesia （CSEA） group and combined epidural anesthesia（CEA） group, each of 20 ases. And we observed anesthesia induction time, additional anesthetic dosage and evaluation of anes- thesia, recorded the first and fifth minute neonate Apgar grades, rates of hypotension, nausea, vomiting and headache of 2 groups. Results Patients of CSEA group showed shorter anesthesia induction time,lower addi- tional anesthetic dosage and better evaluation of anesthesia （ P 〈 0. 05 ）. There was no statistically significant difference in the first and fifth minute neonate Apgar grades and rates of hypotension, nausea, vomiting and headache. Conclusion Compared with CEA, CSEA for cesarean section showed faster anesthesia induction and better evaluation of anesthesia, but no statistically significant difference in effects for neonate and complica- tion.