腰麻一硬膜外联合阻滞和硬膜外麻醉在剖宫产术中的效果观察

目的观察腰麻一硬膜外联合阻滞（CSEA）和硬膜外麻醉（EA）在剖宫产术中的临床效果，探讨CSEA在剖宫产术中的可行性。方法选择ASAI-Ⅱ级足月剖宫产产妇90例，随机分成A组（CSEA组）45例和B组（EA组）45例，记录两组椎管内麻醉阻滞情况、术中呼吸循环功能、麻醉效果及不良反应情况。结果两组SBP、DBP、HR麻醉后均有一过性降低，正确处理后呼吸循环功能趋向稳定，不良反应、新生儿Apgar评分差异无统计学意义（P〉0．05），A组的麻醉效果明显优于B组（P〈0．05）。结论剖宫产手术使用CSEA麻醉效果确切，肌松良好．起效时间快，并发症少．手术的可行性、舒适性明显优于EA法。

Clinical observation of epidural anesthesia and combined spinal and epidural anesthesia in cesarean section

Objective To observe the clinical effect of epidural anesthesia（EA） and combined spinal and epidural anes- thesia （CSEA） in cesarean section,so as to investigate the feasibility of CSEA in cesarean section. Methods 90 cases of full-term cesarean section puerperaes with ASA I -11 were selected and they were all divided into A group（CSEA group） and B group（EA group）,with 45 cases in each group.The spinal anesthesia block,intraoperative breathing and cir- culation function,anesthesia effect and adverse reaction of the two groups were recorded. Results Both the two groups of SBP, DBP, HR were all lower after anesthesia,and the respiratory and circulatory function tended to stable after correct treatment.The differences of adverse reactions,neonatal Apgar score between the two groups were all no statistically sig- nificant （P〉0.05）.The anesthesia effect in A group was obviously better than that of B group （P〈O.05）. Conchmion The anesthesia effect of CSEA applied to in cesarean section is obvious,and with good muscle relaxation,quick effect time, fewer complications.The feasibility and comfort of CSEA is obviously higher than that of EA method.