剖宫产术不同麻醉方法对麻醉效果与新生儿的影响

目的观察腰硬联合麻醉与硬膜外麻醉用于吾4宫产手术的临床效果，进一步提高手术麻醉效果。方法将140例剖宫产手术产妇随机分为两组，每组70例。在剖宫产手术过程中，实验组采用腰硬联合麻醉方法，对照组采用单纯硬膜外麻醉方法，对比两组产妇手术的麻醉效果及新生儿出生后1、5minApgar评分、麻醉前及麻醉后产妇的血压、心率变化和麻醉用药量及麻醉期间的不良反应等变化情况。结果实验组麻醉的起效时间明显比对照组短，麻醉用药量也更低。两组比较差异有统计学意义（P〈0．05）。两组新生儿Apgar评分及两组产妇麻醉前后的血压和心率，差异无统计学意义（P〉0．05）。实验组的不良反应发生率明显低于对照组，差异有统计学意义（P〈0．05）。结论在行剖宫产手术的产妇中，采用腰硬联合麻醉方法具有起效快、不良反应少的优点，对产妇、新生儿的安全性更高，值得临床推广应用。

Effects of different anesthesia methods on anesthesia and newborn in cesarean section

Objective To observe the clinical effect of combined spinal-epidural anesthesia and epidural anesthesia on cesarean section operation, in order to further improve the anesthesia effect in op-eration. Methods One hundred forty cases of maternal cesarean section admitted in our hospital were randomly divided into two groups, with 70 cases in each group. In cesarean section operation process, the patients in experiment group （ group A） were given implementation of combined spinal-epidural anes- thesia, and the patients in control group （group B） were given simple epidural anesthesia. The anesthe- sia effect and 1 min, 5 min after birth Apgar score of neonatal, maternal blood pressure, heart rate, nar- cotic drugs dosage and anesthetic adverse reactions before and after anesthesia were compared between the two groups. Results The onset time of anesthesia in experimental group was significantly shorter than that in the control group, and the anesthesia drugs dosage was lower in experimental group. There were significant differences between the two groups （ P 〈 0.05 ）. There were no significant differences in neo-natal Apgar score and maternal blood pressure and heart rate before and after anesthesia of the two groups （P 〉 0.05 ）. Adverse reactions in the experimental group were significantly lower than those in the con-trol group, there were significant differences （P 〈 0.05 ）. Conclusions In cesarean section, compared with epidural anesthesia, combined spinal-epidural anesthesia has the advantages of quick effect, less ad- verse reaction, high safety of maternal and neonatal, so is worth promoting in clinics.