三种麻醉方法用于剖宫产手术临床效果比较  

Comparison of three anesthesia methods for cesarean section

作　　者：史晓燕[1] 罗宝林[1] 

机构地区：[1]北京丰台医院南院麻醉科,北京100070

出　　处：《临床和实验医学杂志》2009年第5期28-29,共2页Journal of Clinical and Experimental Medicine

摘　　要：目的比较单次硬膜外麻醉、腰-硬联合麻醉、连续硬膜外麻醉在剖宫产手术中的效果。方法急诊手术240例,随机分为3组,A组为单次硬膜外麻醉,B组为腰-硬联合麻醉,C组为连续硬膜外麻醉。术中观察平均动脉压、心率、血氧饱和度,记录麻醉效果和起效时间、局麻药用量及术中、术后并发症。结果3组患者在平均动脉压、心率、血氧饱和度差异无统计学意义(P>0.05),A组患者麻醉效果最好,满意率100%,B组次之,C组最差;起效时间,B组最快,A组次之,C组最慢,C组与A、B间有显著性差异。局麻药用量B组最少。术中、术后并发症A组有低血压4例,B组有低血压12例,恶心呕吐4例;术后头痛9例;C组低血压5例,恶心呕吐1例。三组患者均无全脊髓麻发生。结论单次硬膜外麻醉用于剖宫产手术是最好的麻醉方法。Objective To compare the single epidural anesthesia, combined spinale-pidural anesthesia, and continuous epidural anesthesia for cesarean section. Methods Two hundred and forty patients with emergency operation were randomly divided into three groups with 80 patients in each group. Single epidural anesthesia, combined spinal - epidural anesthesia and continuous epidural anesthesia were used in group A, group B and group C respectively. Mean arterial pressure （MAP）, heart rate （HR）, pulse oximetry oxygen saturation （SpO2 ）, anesthesia effect, effect time and local anesthesia dosage during the operation were observed. Complications during and after the operation were recorded. Resuits There were no significant differences in MAP, HR and SpO2 in the three groups. The best anesthesia effect was observed in patients in group A with a satisfaction rate of 100%, the next was group B, then groups C. There were significant differences in the anesthesia effect when groups C was compared with group A and group C compared with group B. For local anesthesia dosage groups B was the minimal. Considering complications, low blood pressure occurred in 4 cases in group A, 12 cases in groups B and 5 cases in group C. Other complications included nausea and vomit in 4 cases in group B and 1 case in group C, and headache in 9 cases in group B. Total spinal anesthesia did not occur in three groups. Conclusion Single epidural anesthesia is the best method for cesarean section.

关 键 词：剖宫产 单次硬膜外麻醉 腰-硬联合麻醉 连续硬膜外麻醉 

分 类 号：R614[医药卫生—麻醉学]