甲氧胺复合麻黄碱对剖宫产术腰-硬联合麻醉低血压的预防  

Methoxyamine and ephedrine in prevention of hypotension in combined spinal epidural anesthesia for cesarean section

作　　者：王晓伟 杨生华 崔秋美 

机构地区：[1]山东省平度市中医医院麻醉科,266011

出　　处：《辽宁医学杂志》2015年第5期265-267,共3页Medical Journal of Liaoning

摘　　要：目的研究预注甲氧胺复合麻黄碱对剖宫产术腰-硬联合麻醉低血压的预防效果及安全性。方法150例择期剖宫产术孕产妇随机分为3组(n=50)。对3组患者静脉预注升压药物:A组患者给予甲氧胺4mg,B组患者给予麻黄碱10mg,C组患者给予甲氧胺2mg+麻黄碱5mg。监测并比较各组患者麻醉前后收缩压(SBP)、心率(HR)、不良反应情况及新生儿脐动脉血p H、1分钟和5分钟Apgar评分。结果 3组SBP差异无显著性,麻醉预注后10分钟、15分钟时B组HR明显比A组快(P<0.05),C组HR最为平稳。总体不良反应C组显著少于B组(P<0.05),A、C两组新生儿脐动脉血p H显著高于B组(P<0.05),3组新生儿1分钟和5分钟Apgar评分比较差异无显著性。结论甲氧胺复合麻黄碱预防剖宫产术患者腰-硬联合麻醉低血压安全、有效,且能够使患者心率更加平稳,新生儿酸碱平衡更加稳定,值得临床推广应用。Objective To research the preventice effect and safety of methoxamine and ephedrine on combined spinal -epidural anesthesia-associated hypotension in patients with ce sareansection.Methods 150 patients undergoing cesarean section were randomLy divided into three groups （ n=50）.Three groups were given intravenous injection with hypertensors：methoxamine（4mg）was given to A group,ephedrine（10mg）was given to B group,methoxamine（2mg）and ephedrine（5mg） was given to C group.The systobic blood pressure （ SBP）、heart rate （ HR）、adverse reactions and umbilical arterty blood pH、Apgar at 1min and 5min of newborn were checked and compared .Results The SBP of the three groups had no signifi-cant difference.The HR of the B group at 10min and 15min after anesthesia injection were significantly faster than that of A group（ P〈0.05 ） ,and that of C group was the most stable .The adverse reactions of C group was significantly less than that of B group（P〈0.05）,the umbilical arterty blood pH of newborn of A and C group were significantly higher than that of B （P〈0.05）,the Apgar at 1min and 5min of newborn had no significant difference.Conclusion Using methoxamine and ephedrine on combined spinal-epidural anesthesia-associated hypotension in patients with cesarean section is safe and effec-tive,and it is helpful to stabling HR and the acid-base balance of the newborn which is worthy to recommand its clinical use .

关 键 词：剖宫产术 腰-硬联合麻醉 低血压 甲氧胺 麻黄碱 

分 类 号：R614[医药卫生—麻醉学]