剖宫产术中2种椎管内麻醉方法的效果比较  

Comparison of two intravertebral anesthesias in cesarean section

作　　者：樊雅玲[1] 陈旭[2] 李元[1] 张慧伟[1] 金亮[1] 

机构地区：[1]乐山市人民医院麻醉科,四川乐山614000 [2]四川省妇幼保健院麻醉科,四川成都610031

出　　处：《现代临床医学》2017年第2期115-116,119,共3页Journal of Modern Clinical Medicine

摘　　要：目的:比较剖宫产术中采用硬膜外麻醉和腰硬联合麻醉的效果及对母婴的影响。方法:将60例ASAⅠ~Ⅱ级产妇随机分为2组,每组30例。在剖宫产术中分别采用硬膜外麻醉(E组)和腰硬联合麻醉(C组)。比较2组平均动脉压(MAP)、麻醉起效时间、平面到达T_6时间、肌松效果、新生儿Apgar评分及新生儿脐动脉血气分析等指标。结果:C组麻醉后5 min、10 min、15 min、30 min时点的MAP均较E组低(P<0.05),麻醉起效时间及平面到达T_6的时间C组明显较E组快(P<0.05),肌松效果C组优于E组(P<0.05),2组胎儿娩出后1 min、5 min、10 min新生儿Apgar评分无显著性差异(P>0.05),2组新生儿脐动脉血气分析的pH值、氧分压(PO2)和二氧化碳分压(PCO2)无显著性差异(P>0.05)。结论:与硬膜外麻醉比较,腰硬联合麻醉用于剖宫产同样是安全的麻醉方法,且具有起效更快、肌松效果更确切的优势。Objective： To compare the effects of epidural anesthesia and combined spinal-epidural anesthesia （CSEA） in cesarean section, and to compare their impacts on parturient and infant. Methods： Sixty parturient aged 18-45 years with ASA Ⅰ or Ⅱ were randomly divided into epidural anesthesia （group E） and CSEA group（ group C） , 30 cases in each group. The mean arterial pressure（ MAP）, effective time of anesthesia, time of anesthetic level reaching T6, effect of muscle relaxation, neonatal Apgar score and neonatal arterial blood gas analysis were observed, Results： 5 min, 10 min, 15 min and 30 min after anesthesia, the MAP in group C were significantly lower than that in group E （ P 〈 0. 05 ） ; the effective time of anesthesia and T6 arrival time in group C were significantly faster than those in group E（P 〈0. 05） ; the effect of muscle relaxation in C group was better than that in group E（ P 〈 0. 05 ） ; 1 min, 5 rain and 10 min after delivery, there were no significant differences in neonatal Apgar score between the two groups（P 〉 0. 05 ） ; pH value, PO2 and PCOz of neonates had no significant differences between the two groups （ P 〉 0. 05 ）. Conclusion： Compared with epidural anesthesia, CSEA for cesarean section is also a safe anesthetic method, which has the advantages of faster effectiveness and better effect of muscle relaxation.

关 键 词：硬膜外麻醉 腰硬联合麻醉 剖宫产术 

分 类 号：R614.4[医药卫生—麻醉学] R719.8[医药卫生—外科学]