腰麻硬膜外联合麻醉在妊娠高血压疾病的临床观察

目的:探讨妊娠高血压疾病产妇行腰麻硬膜外联合麻醉的临床效应。方法:比较腰椎3~4行腰硬联合麻醉和腰椎2~3行连续硬膜外麻醉在麻醉平面、药量、起效时间、失败率、下肢运动阻滞及镇痛肌松等方面的效果。结果:腰硬联合麻醉在达到最高平面时间、起效时间均显著短于硬膜外麻醉(P<0.05);局麻药用量腰硬联合麻醉也少于硬膜外麻醉(P<0.05);而麻醉失败率方面腰硬联合麻醉小于硬膜外麻醉(P<0.05);镇痛肌松等方面,腰硬联合麻醉好于硬膜外麻醉,呼吸、循环、新生儿Apgar评分等方面无显著性差异(P>0.05)。结论:无并发症及合并症的妊娠高血压疾病的产妇需急症剖宫产手术时,应立即在腰椎3~4行腰硬联合麻醉。

Clinical observation of combined spinal-epidural anesthesia in parturients with ges-tational hypertension

Objective:To research the clinical effect of combined spinal-epidural anesthesia on parturients with gestational hypertension.Methods:To compare combined spinal-epidural anesthesia at L_(3-4) with continuous epidural anesthesia at L_(2~3) in the aspects of the anesthesia plane,dosage,time of producing effect,incidence of failure,blockage of lower limb motion,analgesia and muscle relaxation.Results:The time of reaching the highest plane and producing effect in combined spinal-epidural anesthesia was obviously shorter than that in epidural anesthesia(P<0.05).The dosage of local anesthetic and incidence of failure in combined spinal-epidural anesthesia was less than those in epidural anesthesia(P<0.05).The analgesia and muscle relaxation in combined spinal-epidural anesthesia were better than those in epidural anesthesia.There was no significant difference in the aspects of respiration,circulation and Apgar score of neonate in these two anesthesia methods(P>0.05).Conclusion:Combined spinal-epidural anesthesia at L_(3-4) should be adopted immediately when parturients suffered from gestational hypertension without complications should accept emergency cesarean sections.