腰硬联合麻醉下剖宫产手术低血压的预防比较  

Comparison of hypotension prevention during complex spinal and epidural anesthesia for cesarean delivery

作　　者：叶露[1] 王文凯[1] 陈慧琦[1] 

机构地区：[1]惠州市惠阳区妇幼保健院院麻醉科,516001

出　　处：《中国实用医药》2010年第3期50-52,共3页China Practical Medicine

摘　　要：目的这些研究旨在比较应用血定安和林格液(LR)预防剖宫产手术在联合腰麻-硬膜外麻醉(CSEA)中低血压的发生。方法120例ASAI-II级,年龄22～38岁剖腹产手术的患者,分为两组。在CSEA前,应用持续输注15min血定安500ml或LR1000ml,采用CSEA,于L2-3或L3-4椎间隙穿刺,成功后使用腰麻针穿刺,注入0.5%布比卡因(9mg),麻醉平面控制在T8-S,术中常规监测ECG、SpO2和BP,并注意维持血液动力学平稳。结果低血压的发生率在LR液组为42%(60例患者中有24例),而血定安组为15%(60例患者中有9例)。低血压发生率的差异有显著意义(P<0.05)结论静脉输注血定安500ml比应用LR液1000ml对减少剖腹产术中由于联合麻醉引起的低血压更有效。Objective The purpose of these researches is to compare about celotusine and compound sodium chloride （LR） in vein apply for the prevention of hypotension during complex spinal and epidural anesthesia （CSEA） for cesarean delivery. Methods 120 patients aged 22 ~ 38 （ ASAⅠ grade Ⅱ） were undergone the cesarean operation, which were divided into two groups. Before CSEA, the patients should be continuously transfused 500 ml celotusine or 1000 ml LR for 15 minutes. Puncture was through between L2-3 or L3-4 into the inter-vertebra during the CSEA. After succeeded spinal anesthesia acus puncture was used, injecting 0. 5% Bupivacaine （9 mg） , and the plane of anesthesia was controlled at TS-S. ECG, SpO2 and BP should be inspected routinely during the operation. Besides, pay attention to maintain blood flow dynamics stable. Results The incidence rate of hypotension was 42% in LR group （ i. e. there were 24 persons among 60 patients） , and it was 15% in celotusine group （ i. e. there were 9 persons among 60 patients）. Therefore, difference in the incidence rate of hypotension had a very prominent significance （ P 〈 0. 05）. Conclusion The apply of 500 ml celotusine in vein is more effective than the one of 1000 ml LR for decreasing hypotension aroused by complex spinal and epidural anesthesia during the cesarean operation.

关 键 词：剖宫产手术 血定安和林格液 椎管内麻醉 低血压 

分 类 号：R614[医药卫生—麻醉学]