腰硬联合阻滞麻醉在基层医院急诊剖宫产的应用价值

目的探讨腰硬联合阻滞麻醉在急诊剖宫产中的应用价值及安全性。方法选择60例急诊剖宫产ASA分级为Ⅰ~Ⅱ级单胎足月妊娠产妇,随机分为CSEA组(n=30)采用腰硬联合阻滞麻醉和EA组(n=30)采用连续硬膜外阻滞麻醉。比较两组术中血流动力学参数、麻醉起效时间、阻滞完善时间、麻醉效果、新生儿娩出Apgar评分、麻醉合并症及副反应。结果两组血流动力学组间和组内比较差异无统计学意义(P>0.05);CSEA组的起效时间、阻滞完善时间明显比EA组短(P<0.05);CSEA组麻醉效果明显优于EA组(P<0.01);两组新生儿Apgar评分比较差异无统计学意义(P>0.05);两组间合并症及副反应发生率差异无统计学意义(P>0.05)。结论 CSEA起效快,麻醉效果确切,肌肉松驰好,副反应发生率低,是基层医院急诊剖宫产手术理想和安全的麻醉方法。

Comparison of the application value of combined spinal-epidural anesthesia in primary hospital undergoing emergency cesarean section

Objective To explore the application value and safety of combined spinal-epidural anesthesia（CSEA）and epidural anesthesia（EA）in emergency cesarean section.Methods 60 cases emergency cesarean section with ASA Ⅰ~Ⅱgrade single-fetus mature pregnant women were randomly divided into two groups.Group CSEA（n=30）received combined spinal-epidural anesthesia and group EA（n=30）received epidural anesthesia.The hemodynamic parameters.The onset time,sensory nerve complete block time and the quality of anesthesia,Apgar score of fetus delivered.The complications and adverse reactions of anesthesia were compared between the two groups.Results No significant differences were observed in hemodynamic changes between two groups（P〈0.05）;the onset time and sensory nerve complete block time of group CSEA was significantly shorter than that in group EA（P〈0.05）;the anesthesia effect was considered significantly better in group CSEA than that in group EA（P〈0.01）.Apgar scores differences were not significant in newborns in both groups（P〈0.05）.There were no significant differences between the groups in the incidence of complications and adverse reactions（P〈0.05）.Conclusion CSEA is a reliable technique which provides more rapid onset of analgesia,and positive muscle relaxation results,the incidence of adverse reactions is low,it is an ideal and safe anesthesia method for emergency cesarean section in primary hospital.