腰-硬联合麻醉时快速输注琥珀酰明胶联合麻黄碱静脉滴注预防剖宫产术中低血压

目的观察腰-硬联合麻醉时快速输注琥珀酰明胶扩容联合麻黄碱静脉滴注预防剖宫产术中低血压的效果。方法选择90例ASAⅠ~Ⅱ级在腰-硬联合麻醉下行剖宫产孕妇,采用随机数字表法随机分为A、B、C组各30例。均于腰麻前10分钟开始快速输液,30分钟内各输入液体量10 ml/kg,A组输入复方氯化钠液,B组输入琥珀酰明胶,C组输入琥珀酰明胶并于产妇平卧后静脉注射麻黄碱10 mg。输药之后,3组均以10 ml/(kg.h)的速度输注乳酸林格氏液维持。对比观察3组麻醉手术期间血压、心率的变化,3组低血压的发生率及不良反应的发生情况。结果 C组麻醉前后血压心率变化小;血流动力学比A、B组稳定(P<0.01或0.05),低血压及恶心呕吐的发生率也明显少于A、B组(P<0.05)。B组血压下降程度及低血压发生率虽小于A组,但组间比较差异无统计学意义(P>0.05)。结论腰-硬联合麻醉期间快速输注琥珀酰明胶扩容联合麻黄碱静脉滴注能有效预防剖宫产术中低血压的发生。

Succinylated Gelatin combined with ephedrine for spinal-epidural anesthesia in prevention of hypotension

Objective To evaluate the efficacy of rapid intravenous infusion of Succinylated Gelatin combined with ephedrine for spinal-epidural anesthesia in prevention of hypotension during cesarean section.Methods Ninety pregnant women with ASA in gradeⅠ~Ⅱ were involved in this study.All the patients underwent cesarean section after spinal-epidural anesthesia and were randomly assigned to groups A,B and C,with 30 cases in each group.The three groups were given rapid infusion 10 minutes before lumbar anesthesia.All kinds of liquid were injected in the amount of 10ml/kg for 30 minutes.The liquid for group A was compound sodium chloride solution,and for group B and C was Succinylated Gelatin.In group C,after successive anesthesia,every pregnant woman was intravenously injected with ephedrine.Changes of blood pressure,heart rate,incidence of hypotension and adverse effect during operation of the three groups were comparatively studied.Results In group C,blood pressure and heart rate after anesthesia were almost the same as those before anesthesia.Compared to groups A and B,the hemodynamic was significantly more stable（P0.01 or P0.05）.Incidence of hypotension,nausea and vomiting in group C was significantly less than groups A and B（P0.05）.In group B,decrease of blood pressure and incidence of hypotension were less than those in group A.There was no significant difference between the two groups（P0.05）.Conclusion in spinal-epidural anesthesia,rapid intravenous infusion of Succinylated Gelatin combined with ephedrine can effectively prevent the hypotension induced by cesarean section.