去氧肾上腺素、麻黄素对腰硬联合麻醉下剖宫产母婴的影响

目的探讨和麻黄素相比,去氧肾上腺素用于腰硬联合麻醉下剖宫产,对母体和新生儿的影响。方法选择择期剖宫产术病人60例,ASAⅠ～Ⅱ级,随机分为两组。分别给予静脉泵注去氧肾上腺素100μg/ml(P组)和麻黄素3mg/ml(E组)维持术中收缩压在基础水平。记录术中HR、BP、SpO2、ECG,采集新生儿脐静脉、脐动脉血监测pH、PO2、PCO2,记录产妇术中恶心、呕吐发生率。结果E组术中HR、RPP高于P组(p<0.05);P组新生儿脐静脉血pH、PO2高于E组(p<0.05);P组术中恶心、呕吐发生率低于E组(p<0.05)。结论和麻黄素相比,去氧肾上腺素用于维持腰硬联合麻醉下剖宫产患者的术中血压,能降低新生儿酸中毒的发生率和降低产妇术中恶心、呕吐的发生率。

EFFECTS OF PHENYLEPHRIN AND EPHEDRINE ON FETUSES AND MATERS DURING COMBINED SPINAL-EPIDURAL ANESTHESIA FOR CESAREAN DELIVERY

Objective To study the effects of phenylephrine and ephedrine on fetuses and Maters during combined spinal - epidural anesthesia for Cesarean Delivery. Methods Sixty ASAⅠ-Ⅱ patients scheduled for selective cesarean section under combined spinal - epidural anesthesia were divided into two experimental groups. It compared phenylephrine 100 μg/ml （phenylephrine group P） and ephedrine 3 mg/ml （ephedrine group E）, given by infusion, to maintain maternal systolic arterial pressure at baseline during cesarean delivery. HR, BP, SpO2 and ECG were continuously monitored during operation. Blood samples were taken from umbilical artery and vein to determine PH, PO2, and PCO2. Maternal nausea and vomiting were also compared. Results The HR and RPP in E group were increased during operation （p 〈0. 05）. Umbilical Venous PH and Venous PO2 in P group were increased （p 〈0. 05）. Maternal nausea and vomiting in P group were lower then E group. Conclusion Giving phenylephrine alone by infusion at cesarean delivery was associated with a lower incidence of fetal acidosis and maternal nausea and vomiting than giving ephedrine alone.