瑞芬太尼联合丙泊酚全麻在剖宫产术中的麻醉效果观察

目的探讨瑞芬太尼联合丙泊酚用于剖宫产全麻的临床疗效。方法 2012年1月至2013年1月我院行剖宫产产妇100例,将50例产妇剖宫产前行腰麻硬膜外联合麻醉作为对照组,50例产妇剖宫产前行瑞芬太尼联合丙泊酚全麻作为观察组。记录2组胎儿娩出后的Apgar评分,测定2组产妇及分娩胎儿的动脉血气分析以及产妇分娩后的血流动力学情况并比较分析。结果2组胎儿娩出1 min、5 min后Apgar评分、PaO2、PaCO2、PH血气指标及2组产妇分娩后动脉血气指标PaCO2、PaCO2、PH比较差异不具有统计学意义(P0.05);观察组产妇切皮时、胎儿娩出、手术结束时MAP、HR血流指标与基础值较为相近,未发生明显变化,而对照组产妇切皮时、胎儿娩出时的MAP以及产妇切皮时的HR明显较基础值明显降低,且低于观察组产妇,P0.05,具有统计学意义。结论瑞芬太尼联合丙泊酚全麻应用于剖宫产安全性及有效性均较好,更利于维持产妇血流动力学的稳定。

Clinical observation of remifentanil and propofol anesthesia for cesarean section during surgery

Objective To explore and analyze the clinical efficacy of remifentanil and propofol anesthesia for cesarean section. Meth. otis From January 2012 to January 2013 ,there were 100 cases of maternal cesarean section in our hospital selected out as clinical research objects, of which 50 cases operated cesarean section before lumbar epidural anesthesia were control group;while other 50 cases conducted an- esthesia before cesarean section were observation group. The Apgar scores of 2 groups of babies after partuition were recorded, the arterial blood gas analysis of both mothers and babies as well as the hemodynamic conditions of the mothers after childbirth were fully conducted in the whole process. Results The Apgar scores of both foetus after their birth time of 1 rain and 5 rains were much more consistent, and so were the figures of Pa02, PaCO2, PH blood gas analysis. Thus the difference was not statistically significant （ P 〉 0.05 ）. Besides, that also held true for the two groups of mothers. The MAP and HR figures of patients in observation group during the maternal skin incision operation and the delivery of the baby, as well as at the end of surgery were much closer to the basic values,which showed no significant changes （ P 〈 0.05 ）. However,that of patients in control group had decreased evidently and were lower than control group ,the difference was statistical significance（ P 〈 0.05 ）. Conclusion The remifentanil and propofol anesthesia for cesarean section is of better application safety and efficacy, and is more conducive to the maintenance of maternal hemodynamic stability.