七氟醚复合瑞芬太尼在剖宫产手术中的效果观察  

Effects of sevoflurane inhalation combined with iv injection of remifentanil in cesarean section

作　　者：吴政元[1] 黄小娟[1] 卢先卿[1] 张建华[1] 

机构地区：[1]肇庆市第一人民医院麻醉科,526021

出　　处：《国际医药卫生导报》2011年第16期2021-2023,共3页International Medicine and Health Guidance News

摘　　要：目的探讨七氟醚复合瑞芬太尼在剖宫产手术中的麻醉效果，并与异氟醚复合芬太尼比较。方法将需剖宫产手术的ASAI～Ⅱ级的足月产妇40例（23～32岁）随机分为七氟醚复合瑞芬太尼组（I组）和异氟醚复合芬太尼组（Ⅱ组）各20例。诱导：I组面罩吸入3．5％七氟醚、2～4L／min流量的氧气、静脉输入瑞芬太尼1μg／kg、丙泊酚1mg／kg、顺苯阿曲库铵0．1mg／kg；Ⅱ组静脉注芬太尼0．02mg／kg、丙泊酚2mg／kg、顺苯阿曲库铵0．1mg／kg。维持：I组吸入1．5％～3．5％七氟醚，胎儿娩出后输注瑞芬太尼0．15μg／（kg·min）；I组吸人1％～2．5％异氟醚，胎儿娩出后静脉注芬太尼0．02mg／kg。取新生儿脐动脉（UA）血样1ml行血气分析。分别记录两组麻醉期间血流动力学的参数、血氧饱和度（SpO2）的变化、麻醉复苏的时间、术中知晓情况以及新生儿Apgar评分、脐动脉血气分析。结果I组诱导后和手术时心率、血压基本保持平稳沪〉0．05）。II组在诱导后心率和血压下降较I组明显（p〈0．05），术后产妇拔管时间【（10．3±3．2）mini和睁眼时间[（15．4±2．3）min】I组明显早于Ⅱ组[（18．5±6．3）min，（25．6±3．5）min]，差异有显著性垆〈0．05）。两组新生儿1、5、10minApgar评分均大于7分，脐动脉血气分析差异无显著性垆〉0．05l两组均未见新生儿呼吸抑制及产妇术中知晓发生。结论吸入七氟醚联合瑞芬太尼在剖宫产手术中的麻醉平稳、效果确切、苏醒快、新生儿无呼吸抑制。Objective To investigate the effects ofsevoflurane inhalation combined with iv injection ofremifentanil in cesarean section, and to compared with isoflurane combined with fentanyl. Methods Forty ASA Ⅰ -Ⅱ puerperas （23-32 years old） were randomly divided into 2 groups： sevoflurane group （ I group） and isoflurane group （Ⅱ group）, 20 cases for each group. Group I was induced with mask inhalation of 3.5% of sevoflurane in 2-4 L/minutes oxygen and iv injection of remifentanil 1μg/kg, propofol 1 mg/kg and benzene cisatracurium 0.1mg/kg; group Ⅱ were induced with injectionoffentanyl0.02mg/kg, propofol2mg/kgandbenzenecisatracurium0.1 mg/kg. Anesthesia maintenance patients in I group were inhaled with 1.5%-3.5% sevoflurane, then administrated remifentanil 0.15 μ g/（kg＇min） by intravenous injection after foetus delivery; patients in I group were inspired 1.0%~2.5% isoflurane , then administrated fentanyl 0.02 mg/kg by intravenous injection after foetus delivery. Blood samples were taken from umbilical artery（UA） within 1 minute after the delivery of the baby for blood gas analysis. SBP, DBP, SPO2, HR, the anesthesia recovery time, the Apgar scores at 1, 5 and 10 minutes after the delivery of the baby and the umbilical artery blood gas analysis results of these newborns were be recorded.Results The heart rate and the blood pressure in group I maintain steady basically in induction and surgery（P 〉 0.05）. The heart rate and the blood pressure in group 11 compare Ⅰ group obvious decreased after induction （P〈 0.05）. The time of extubation （10.3 ± 3.2） minutes and opening eyes （15.4 ±2.3） minutes independently was obviously earlier in group I than in group Ⅱ（18.5 ±6.3） minutes, （25.6 ± 3.5） minutes after the surgery（P〈 0.05）.Apgar scores and umbili- cal artery blood gas analysis results of two groups were similar. （P〉 0.05）; There were no respiratory depression in the tow groups of newborns and no intraoperative awareness in the tow groups of mater

关 键 词：七氟醚 瑞芬太尼 剖宫产 

分 类 号：R614[医药卫生—麻醉学]