腰硬联合麻醉在剖宫产术中应用的安全性研究

目的:探讨腰硬联合麻醉在剖宫产术中应用的安全性。方法:选择2008年1月～2009年12月行剖宫产术麻醉孕妇200例,病例ASAⅠ～Ⅱ级,术前没有胎儿宫内窘迫,所有患者随机分为A组(腰硬联合麻醉)和B组(硬膜外麻醉)各100例,观察比较两组的麻醉效果。结果:腰硬联合麻醉组MAP、HR、SpO2均较硬膜外麻醉组改善明显,差异有统计学意义。腰硬联合麻醉组的麻醉起效时间及胎儿娩出时间均明显少于硬膜外麻醉组,差异有统计学意义。两组新生儿Apgar评分5min比较差异无统计学意义。腰硬联合麻醉组不良反应如血压下降、心率缓慢、呼吸抑制、恶心、呕吐的发生例数均明显少于硬膜外麻醉组,差异有统计学意义。结论:腰硬联合麻醉具有作用迅速、阻滞满意、镇痛肌松效果确切的优点,用于剖宫产手术麻醉效果好,值得临床推广和应用。

The safety of lumbar epidural anesthesia during cesarean section

Objective:To study the security of combined spinal-epidural anesthesia in cesarean section.Methods:200 cases of pregnant women with cesarean section anesthesia from January 2008 to January 2010 in this hospital, ASA Ⅰ-Ⅱ level, without fetal distress before surgery, were randomly divided into A group (spinal and epidural anesthesia ) and B (epidural anesthesia) of the 100 cases to compare the observed effects of anesthesia.Results:Of lumbar epidural anesthesia group, MAP, HR, SpO2 significantly improved compared with those of epidural anesthesia group. Spinal and epidural anesthesia onset time of anesthesia and the baby was delivered were all significantly less than those of the epidural anesthesia group. However, neonatal Apgar score 5 min compared the two groups, the difference was not significant. Spinal and epidural anesthesia group, adverse events, such as blood pressure, slow heart rate, respiratory depression, nausea, and vomiting were significantly less than the number of cases of epidural anesthesia group.Conclusion:The effect of lumbar epidural anesthesia with rapid, block satisfaction, analgesic effects of muscle relaxation benefits of precise, effective anesthesia for cesarean section, is worthy of promotion and application.