曲马多、氟哌利多复合辅助硬膜外麻醉剖宫产对新生儿Apgar评分的影响

[目的]探讨曲马多、氟哌利多复合辅助硬膜外麻醉剖宫产时对新生儿Apgar评分、母婴安全的影响.[方法]采用随机双盲方法,选择 60例孕足月单胎产妇 (ASAⅠ～Ⅱ级)随机分为三组:静注生理盐水0.05 mL/kg为对照组(C组 );静注曲马多1 mg/kg为曲马多组(T组)和静注曲马多1 mg/kg 氟哌利多2.5 mg组为曲氟组(TD组),每组20例.在连续硬膜外麻醉下行剖宫产术,于切皮前5 min缓慢静脉给药,持续监测产妇血压、心率、血氧饱和度,并记录恶心呕吐、寒颤及牵拉不适的发生情况 ,新生儿行1,5,10 min Apgar评分.[结果]三组产妇血压、心率、血氧饱和度变化差异不具有显著性(P＞0.05).三组新生儿Apgar评分差异不具有显著性(P＞0.05).三组产妇恶心呕吐,寒颤、牵拉不适等不良反应的发生率差异具有显著性(P＜0.05),TD组的不良反应发生率明显降低.[结论]曲马多复合氟哌利多辅助硬膜外麻醉剖宫产时对新生儿Apgar评分无明显影响,对产妇安全,且能够减轻产妇呕吐、寒颤及牵拉不适等不良反应的发生.

Effect of Tramadol Combined with Droperidol in Cesarean Section under Epidural Anesthesia on Apgar Score of Neonates

[Objective] To investigate effect of tramadol combined with droperidol in cesarean section under epidural anesthesia on Apgar score of neonates and the safety of pregnant women.[Methods] A randomized double-blind study was conducted.Sixty cases of single full-term parturients undergoing cesarean section under epidural anesthesia were divided into three groups with twenty cases each :intravenous tramadol group(T),tramadol combined with droperidol(TD)and control group(C).At 5min before skin incision,drugs were slowly intravenously administrated.Blood pressure(BP),heart rate(HR),SPO2 during operation were continuously monitored,and the incidence of side effects such as PONV,shivering and dragging,and Apgar score of neonates at 1,5,10 min were recorded and compared.[Results] There were no significant differences in three groups for BP,HR,SPO2 during operation and Apgar score of neonates(P>0.05).There were also significant differences in three groups for PONV,shivering and dragging reaction of parturients,and the incidence rate of the adverse effects in TD group was lower than that in the others.[Conclusion]Tramadol combined with droperidol in Cesarean section under epidural anesthesia has no effect on Apgar score of neonates,and it can alleviate the incidence of adverse reactions.