西宁地区快速诱导全身麻醉在剖宫产术中的应用研究

目的对西宁地区剖宫产术中开展的快速诱导全身麻醉方法进行相关研究，为低氧环境下应用该麻醉方法提供科学依据。方法对50例足月妊娠产妇在快速诱导全身麻醉下行剖宫产术，应用丙泊酚（1．5～2mg／kg）、瑞芬太尼（1恤g／kg）、维库溴铵（0．05～0．1mg／kg）静脉滴注行快速诱导。胎儿娩出后静脉输注瑞芬太尼（0．1～0．5μg／kg·min）、丙泊酚（4—12mg／kg·h）维持麻醉，根据麻醉深度调节药物用量。持续监测产妇的呼吸和循环参数。比较诱导前、后及插管后1min、5min即刻产妇的BP、HR、SpO2。新生儿娩出后1、5min进行Apgar评分，统计麻醉开始至手术的时间，并与椎管内麻醉下行剖宫产术的相关参数进行比较。结果全身麻醉产妇在诱导和插管过程中血压（BP）和心率（HR）有一定的波动：麻醉诱导后血压低于诱导前，插管后有所回升，且于插管后1min时收缩压稍高于诱导前（P〈0．01），HR于诱导后及插管后1min时有所增加（P〈0．01），但插管后5min时BP和HR均恢复到诱导前水平（P〉0．05）。然而，SpO：在诱导和插管过程中无明显变化。全身麻醉组麻醉诱导至胎儿娩出时间（I—D）均≤10min，I—D〉5min与≤5min者比较，新生儿1min Apgar评分及5min Apgar评分无统计学差异（均P〉0．05）。全身麻醉组麻醉开始至手术时间比椎管内麻醉组短（P〈0．01），两组间手术开始至新生儿娩出时间、新生儿1min Apgar评分和5min Apgar评分均无统计学差异（P〉0．05）。结论西宁地区低氧环境下应用快速诱导全身麻醉施行剖宫产术安全、可行。

APPLICATION OF THE RAPID SEQUENCE INDUCTION ANESTHESIA IN CESAREAN SECTION IN XINING CITY

Objective This paper aims to observe the safety and feasibility of cesarean section when it is operated under the rapid sequence induction general anesthesia in Xining where is considered hypoxia area. Methods 50 full - term pregnant women were performed cesarean section underwent the rapid sequence induction general anesthesia（ Vecuronium 0.05 - 0.1 mg/kg, Remifentanil 1 μg/kg, Propofoll. 5 - 2mg/kg）. Maintain the Remifentanil 0.1 -0.5μg/kg/min, Propofol 4 - 12mg/kg· h after the opertion. Keep monitoring the condition of respiration and circulation. To observe the BP, HR and SpO2 of pregnant before and after Induction and afterTracheal intu-bation 1 rain and 5min. To observe the neonatal APGAR scores in 1 min and 5 min. To compare the records with those under the Intrathecal Anesthesia. Results The BP and HR of the pregnantshowed a degree of variation in the process of Induction and Tracheal intubation： BP was lower after Induction than before Induction and gradually return some degree after Tracheal intubation. The BP after Tracheal intubation 1 min was higher than Induction before （ P 〈 0.01 ）. HR increased after the Induction 1 rain and Tracheal intubation 1 min （ P 〈 0.01 ）. The BP and HR returned to the level of lnduction （P 〉 0.05 ）. The SpO2 wasnot changed evidently in the process of Induction and Tracheal intubation. The time between Induction and Delivery is ≤ 10 min. There is no statistical difference in neo- natal 1 min and 5 min APGAR scores （ P 〉 0.05 ）. The time between the general anesthesia and operation wasshorter than the Intrathecal Anesthesia. There wasno statistical difference in time between operation and delivery under the general anesthesia and the Intrathecal Anesthesia. The neonatal APGAR scores were no statistical difference be tween the general anesthesia and the Intrathecal Anesthesia（ P 〉0.05）. Conclusion It＇s safe and feasible when cesarean section is carriedout under the rapid sequence induction general anesthesia in Xining area.