万汶预扩容联合小剂量麻黄碱在腰硬联合麻醉下剖宫产术中的运用

目的:观察万汶(羟乙基淀粉130/0.4)与小剂量麻黄碱联合使用在腰硬联合麻醉(CSEA)下剖宫产术中的效果。方法:将万汶与麻黄碱联合用于CSEA下剖宫产手术患者,观察其对CSEA下剖宫产手术患者低血压、恶心、呕吐、胸闷的防治效果,用来增加剖宫产手术麻醉的安全性并减少并发症的发生。结果:Ⅰ组、Ⅱ组、Ⅲ组与Ⅳ组相比能够显著减少低血压、恶心、呕吐、胸闷的发生率(P<0.05),Ⅰ组与Ⅱ组、Ⅲ组相比能够减少低血压、恶心、呕吐、胸闷的发生率(P<0.05),Ⅲ组与Ⅰ组、Ⅱ组、Ⅳ组相比在麻醉后1、3、5 min有一过性心率增快(P<0.05),在麻醉15 min后(胎儿娩出后),Ⅲ组与Ⅰ组、Ⅱ组相比低血压发生率高(P<0.05)。Ⅰ组、Ⅱ组、Ⅲ组、Ⅳ组相比寒战发生率差异无统计学意义(P>0.05)。结论:万汶预扩容联合小剂量麻黄碱能有效预防CSEA下剖宫产术中的低血压、恶心、呕吐、胸闷的发生,是一种可行的方法。

Application of pre-anesthetic volume expansion with voluven combined with small dose of ephedrine in cesarean section under combined spinal-epidural anesthesia

Objective:To observe the effect of voluven(hydroxyethyl starch 130/0.4) combined with small dose of ephedrine in cesarean section under combined spinal-epidural anesthesia(CSEA).Methods:Voluven and ephedrine were used for patients receiving cesarean section under CSEA to increase the safety of cesarean section and reduce complications,the effects of prevention and treatment for hypotension,nausea,vomiting,chest distress were observed.Results:Compared with group Ⅳ,the incidences of hypotension,nausea,vomiting and chest distress in groupⅠ,group Ⅱ and group Ⅲ decreased significantly(P<0.05);compared with group Ⅱ and group Ⅲ,the incidences of hypotension,nausea,vomiting and chest distress in groupⅠ decreased significantly(P<0.05);compared with groupⅠ,group Ⅱ and group Ⅳ,at 1 minute,3 minutes and 5 minutes after anesthesia,temporary tachycardia occurred(P<0.05);compared with groupⅠ and group Ⅱ,at 15 minutes after anesthesia(after delivery),the incidence of hypotension in group Ⅲ increased significantly(P<0.05);there was no significant difference in incidence of shivering among the four groups(P>0.05).Conclusion:Pre-anesthetic volume expansion with voluven combined with small dose of ephedrine in cesarean section under CSEA can prevent the occurrence of hypotension,nausea,vomiting,chest distress,which is a feasible method.