预充万汶对腰硬联合麻醉下剖宫产产妇血流动力学及血糖的影响

目的:观察预充新一代中分子羟乙基淀粉(万汶)对腰硬联合麻醉(CSEA)下剖宫产产妇术中血流动力学及血糖的影响。方法:将40例拟在CSEA下行择期剖宫产的产妇随机分为万汶组(V组)和乳酸林格氏液组(L组)各20例,在麻醉前30min内分别输入乳酸林格氏液及万汶500ml,监测记录麻醉前、麻醉后的血糖(BG)变化及麻醉前、麻醉后3min、5min、手术结束时的心率(HR)、收缩压(SBP)、舒张压(DBP)。结果:麻醉后3min、5min时BP、HR及麻黄素平均需要量两组间差异显著(P<0.05);两组术中BG差异不明显(P>0.05)。结论:预充万汶可以改善在CSEA下剖宫产母体血流动力学,降低低血压的发生率,同时两组产妇血糖水平无明显差异。

Effect of voluven preload on hemodynamics and blood glucose during cesarean section under combined spinal epidural anesthesia

Objective:To observe and compare the effects of voluven and Ringers solution preload on hemodynamics and blood glucose during cesarean section under combined spinal epidural anesthesia.Methods:40 patients scheduled for cesarean section under combined spinal epidural anesthesia were randomly divided into voluven group(group V n=20)and Ringers solution group(group L n=20).The two groups received 500 ml of voluven or Ringers solution prior respectively 30 min before anesthesia.BG,HR,BP were recorded 3min,5 min before and after anesthesia.Results:There were significant differences between BP,HR and the mean dose of ephedrine(MDOE)required 3 min,5 min after anesthesia(P<0.05).Conclusion:Voluven preload can remarkably maintain hemodynamics stable and decrease hypotension rate,at the same time there is no harmful effect to concentration of blood glucose.