肥胖产妇剖宫产术59例麻醉分析

目的探讨肥胖产妇剖宫产术的麻醉处理方法及效果。方法选择在该院行剖宫产的59例肥胖产妇,常规监测血氧浓度、心率、血压、呼吸,并行硬腰联合麻醉。结果 36例产妇穿刺顺利,脑脊液回流通畅,麻醉效果优;19例产妇脑脊液回流不通畅改用硬膜外麻醉完成手术;4例产妇穿刺困难改用气管插管全麻。所有婴儿1分钟Apgar评分均为7～10分,产妇产后恢复良好。结论椎管内麻醉为肥胖产妇剖宫产术的较好的麻醉方式,其次为硬膜外麻醉方式,麻醉过程中均应特别重视气道和循环的管理。

Analysis of anesthesia for obese parturients undergoing caesarean section:reports of 59 cases

Objective To investigate the anesthesia methods and effects for obese parturients undergoing caesarean section.Methods In our hospital,59 obese parturients underwent caesarean section under the combined spinal and epidural anesthesia.Their oxygen concentration,heart rate,blood pressure,breathing were monitored.Results In 36 parturients,punctures was successfully completed,cerebrospinal fluid flow was unobstructed,excellent anesthetic effect was got.In 19 parturients cerebrospinal fluid flow was not smooth,these parturients underwent epidural anesthesia to complete the operation.Four parturients underwent endotracheal intubation general anesthesia because of puncture difficulties.In all infants,1 min Apgar score was 7~10.The postpartum recovery was good in these parturients.Conclusion For parturients undergoing caesarean section intraspinal anesthesia is preferred anesthesia,followed by epidural anesthesia.During anesthesia it should be paid special attention to the management of the airway and circulation.