多聚明胶肽用于剖宫产腰麻联合硬膜外麻醉的临床观察

目的: 观察麻醉开始时输注多聚明胶肽在剖宫产腰麻联合硬膜外麻醉(combined epidural and spinal anesthesia,CESA)中预防低血压等不良反应的效果。方法: 选择40例ASAⅠ~Ⅱ级CESA下剖宫产患者,随机分为两组(n=20),麻醉开始时分别输注多聚明胶肽(F组)和乳酸钠林格液(L组)。观察各时间点的收缩压(SBP)、心率(HR)的变化、低血压发生率和恶心呕吐及应用麻黄碱的情况。结果: L组在麻醉后SBP下降幅度明显高于F组(P<0.05~P<0.001),低血压发生率和恶心呕吐及应用麻黄碱的例数均高于F组(P<0.05)。而HR的变化两组之间差异均无显著性(P>0.05)。结论: 麻醉开始时输注多聚明胶肽能有效地预防低血压等不良反应的发生。

Use of polygeline during combined epidural and spinal anesthesia in cesarean section

Objective: To observe the effect of polygeline in preventing hypotension and other side effects during combined epidural and spinal anesthesia(CESA) in cesarean section.Methods: Forty cases of ASA grade Ⅰ-Ⅱ receiving selective cesarean section under CESA were randomly divided into two groups(n=20).At the beginning of the anesthesia,each group were infused 500 ml polygeline and lactated ringer solution.The changes of systolic blood pressure(SBP) and heart rate(HR) before and after anesthesia,the side effects such as the incidence of hypotension,nausea and vomiting,and the number of cases using ephedrine were observed.Results: The SBP decreased significantly in L group compared with F group(P<0.05-P<0.001).The incidence of hypotension,nausea,vomiting and the cases using ephedring were significantly higher in L group than that in F group(P<0.05),but there was no significant difference in HR (P>0.05).Conclusions: Preloading infusion during combined epidural and spinal anesthesia may effectively prevent hypotension and other side effects in cesarean section.