剖宫产手术中3种不同麻醉方式的临床比较

目的了解剖宫产手术中单纯硬膜外麻醉（EA）、腰麻-硬膜外联合麻醉（CSEA）和静脉麻醉（IA）的临床效果。方法急诊剖宫产手术180例,随机分为3组,A组为单纯硬膜外麻醉,B组为腰麻-硬膜外联合麻醉,C组为静脉麻醉。观察麻醉前、麻醉后（5,10,30 min）术毕、术后2 h的血压、心率、血氧饱和度,记录麻醉效果和起效时间、Bromage评分、术中、术后不良反应以及新生儿Apgar评分。结果 3组产妇在血压、心率、血氧饱和度、新生儿Apgar评分和不良反应差异无统计学意义（P〉0.05）,麻醉效果满意率、麻醉起效时间和Bromage评分差异有统计学意义（P〈0.05）。结论 EA用于剖宫产手术存在麻醉诱导时间长、骶神经阻滞不完善、特别是膀胱腹膜反折处疼痛以及肌松欠佳等缺点,新生儿Apgar评分与其他两组相比略有偏低,但差异无统计学意义（P〉0.05）;IA用于剖宫产对新生儿安全无明显影响;选用CSEA较佳,操作方便,麻醉平面易控制,成功率高,且费用少,可视为剖宫产术的首选麻醉方法。

Caesarean section three different methods of clinical anesthesia comparison

Objective To understand the clinical effects of caesarean section with epidural anesthesia(EA),spinal anesthesia-epidural anesthesia(CSEA) and intravenous anesthesia(IA).Methods 180 cases of emergency cesarean section were randomly divided into 3 groups,with A group treated by pure epidural anesthesia,B group by spinal anesthesia-epidural anesthesia,and C group by intravenous anesthesia.Observed the intraoperative mean arterial pressure,heart rate,oxygen saturation;recorded the onset time of narcotic effect...