坐位蛛网膜下隙与硬膜外隙联合麻醉在择期剖宫产术中的效果观察  

Efficacy of combined spinal epidural anesthesia with sitting position in parturient women undergoing elective cesarean section

作　　者：卓进德 

机构地区：[1]浙江省温州市龙湾区第一人民医院麻醉科,325024

出　　处：《中国医师进修杂志》2011年第18期4-5,共2页Chinese Journal of Postgraduates of Medicine

摘　　要：目的观察坐位蛛网膜下隙与硬膜外隙联合麻醉（腰硬联合麻醉）在择期剖宫产术中的效果。方法将100例择期行剖宫产术的产妇按随机数字表法分为对照组和观察组，每组50例，对照组采用左侧卧位腰硬联合麻醉，观察组采用坐位腰硬联合麻醉，比较分析两组的麻醉起效时间、手术时间、麻黄碱用量、新生儿Apgar评分、不良反应。结果对照组3例无随访记录，观察组1例行紧急剖宫产术。观察组麻醉起效时间、麻黄碱用量均小于对照组（P〈0．05）。观察组不良反应发生率[14．3％（7／49）]明显低于对照组[31．9％（15／47）]（P〈0．05）。结论坐位腰硬联合麻醉应用于择期剖宫产术，麻醉起效时间短，麻黄碱用量少，不良反应发生率低，降低了产妇及新生儿的麻醉危险。Objective To investigate the effect of combined spinal epidural anesthesia with sitting position in parturient woman undergoing elective cesarean section. Methods One hundred parturient women undergoing elective cesarean section were divided into two groups by random digits table, 50 cases of control group adopted combined spinal epidural anesthesia with left lateral position, 50 cases of observation group adopted combined spinal epidural anesthesia with sitting position, the onset time of anesthesia, operation time, dose of ephedrine, neonatal Apgar scores and side effects of two groups were compared and analyzed. Results Three cases of control group failed to be followed up, 1 case of observation group performed urgent cesarean section. The onset time of anesthesia and dose of ephedrine of observation group was significantly shorter than that of control group, there was significant difference between two groups （P 〈 0.05 ） ; the operation time and neonatal Apgar scores of two groups were compared, there were no significant differences （P 〉 0.05）; the incidence of side effect of observation group was significantly lower than that of control group [ 14.3%（7/49） vs. 31.9%（15/47） ], there was significant difference （P 〈 0.05 ）. Conclusion Combined spinal epidural anesthesia with sitting position in parturient women undergoing elective cesarean section has satisfactory results, shorter onset time of anesthesia, less dose of ephedrine, lower incidence of side effect, reducing the risk of maternal and neonatal anesthesia.

关 键 词：麻醉 硬膜外 蛛网膜下腔 剖宫产术 

分 类 号：R614[医药卫生—麻醉学]