瑞芬太尼用于剖宫产手术对母体、胎儿及新生儿的影响

目的观察腰硬联合阻滞麻醉下行剖宫产手术静脉应用瑞芬太尼对母体、胎儿及新生儿的影响。方法择期在腰硬联合阻滞麻醉下行剖宫产手术产妇60例,随机分为3组。C组为对照组:生理盐水恒速静脉输注;R1组为瑞芬太尼0.05μg/(kg·min);R2组为瑞芬太尼0.1μg/(kg·min)。记录切皮时产妇的镇静评分及新生儿1分钟和5分钟Apgar评分。胎儿娩出时取母体动脉血、脐动脉和脐静脉血做血气分析。结果R1和R2组切皮时,产妇的镇静评分明显高于对照组(P<0.05),但未观察到产妇有过度镇静的副作用。三组新生儿的1分钟Apgar评分结果均≥8分,5分钟Apgar评分结果均为10分(P>0.05)。脐血血气分析,R2组脐静脉血的pH值明显低于C组(P<0.05)。结论联合阻滞麻醉下行剖宫产手术静脉应用0.05μg/(kg·min)及0.1μg/(kg.min)的瑞芬太尼对母体和新生儿无不良影响。

Effect of intravenous remifentanil used in cesarean section on the parturient and neonate

Objective To observe the effect of remifentanil administered intravenously combined with spinal-epidural anesthesia(CSEA)for cesarean section on the parturient and neonate.Methods Sixty healthy parturients scheduled for cesarean section under CSEA were randomly divided into three groups.Group C(control group)received saline,and Group R1 received 0.05 μg/(kg·min)remifentanil,and group R2 received 0.1 μg/(kg·min)remifentanil intravenously.Maternal vital signs were monitored,and sedation levels were assessed at skin incision.Maternal arterial(MA),umbilical arterial(UA),and umbilical venous(UV)blood samples were obtained at delivery for blood gas analysis.Apgar scores were assessed at 1st and 5th minute.Side effects of parturients and newborns were observed.Results There was a sedative effect on the mothers,but no severe sedation.Results of Apgar scores recorded at 1st and 5th minute were within normal limits.All neonates had Apgar scores ≥8 at 1st minute,and 10 at 5th minute.Umbilical cord blood gas analysis showed decreased mean UV pH in Group R2.There was difference between Group R2 and Group C.Conclusion Maternal sedation occurred in 0.05 μg/(kg·min)and 0.1 μg/(kg·min)remifentanil intravenously administered in CSEA for cesarean section,but without adverse effects on mothers and newborns.