剖宫产病人应用瑞芬太尼复合地氟烷全身麻醉对胎儿的影响研究  

Effect of general anesthesia with remifentanil combined with desflurane on fetus in patients undergoing cesarean section

作　　者：王思亮 沈寿祥 田明 WANG Si-liang;SHEN Shou-xiang;TIAN Ming(Department of Anesthesia,Operation Room,Tianchang Hospital of Traditional Chinese Medicine,Chuzhou 239300,China)

机构地区：[1]安徽省天长市中医院手术室麻醉科,安徽滁州239300

出　　处：《中国实验诊断学》2021年第3期340-343,共4页Chinese Journal of Laboratory Diagnosis

基　　金：安徽省卫生和计划生育委员会科研计划项目(2016QK082)。

摘　　要：目的探讨瑞芬太尼复合地氟烷在剖宫产手术中的运用效果以及对胎儿的影响。方法选择2016年6月-2019年6月本院产科接诊的80例择期行剖宫产手术的单胎足月产妇为研究对象。采用随机数字表法将所选对象分为A、B两组。A组采用瑞芬太尼复合地氟烷进行全身麻醉,B组采用瑞芬太尼进行全身麻醉;对比两组产妇血流动力学指标、麻醉清醒时间、定向力恢复时间;对比两组胎儿Apgar评分、体质量、脐动脉血气分析、麻醉诱导至胎儿娩出时间、子宫切开至胎儿娩出时间、腹膜切开至子宫切开时间等指标。结果 (1)两组产妇各时间点血氧饱和度(SPO2)、心率(HR)以及平均动脉压(MAP)比较均无明显差异(P>0.05);A组麻醉清醒时间、拔管时间、定向力恢复时间均短于B组(P<0.05);(2)两组新生儿Apgar评分均随时间延长而升高(P<0.05);两组各时间点Apgar评分比较无明显差异(P>0.05);两组新生儿体质量、脐动脉血气分析、麻醉诱导至胎儿娩出时间、子宫切开至胎儿娩出时间、腹膜切开至子宫切开时间比较均无明显差异(P>0.05)。结论运用瑞芬太尼复合地氟烷进行剖宫产手术全身麻醉,可提高镇痛效果,产妇血流动力学稳定,苏醒时间短,且对新生儿结局无不良影响。Objective To explore the effect of remifentanil combined with desflurane in cesarean section and the impact on the fetus.Methods From June 2016 to June 2019,80 full-term parturients with single fetus who underwent elective cesarean section were selected as the study objects.The selected objects were divided into two groups A and B by random number table method.Group A received general anesthesia with remifentanil and desflurane,group B received general anesthesia with remifentanil.The hemodynamic indexes,awake time of anesthesia and recovery time of directional force were compared between the two groups.The Apgar score,body mass,blood gas analysis of umbilical artery,time from anesthesia induction to fetal delivery,time from uterine incision to fetal delivery,time from peritoneal incision to uterine incision were compared between the two groups.Results(1)There were no significant differences in blood oxygen saturation(SPO2),heart rate(HR)and mean arterial pressure(MAP)between the two groups(P>0.05).The awake time,extubation time and orientation recovery time of group A were shorter than those of group B(P<0.05).(2)The Apgar scores of the two groups increased with time(P<0.05).There was no significant difference in Apgar scores between the two groups(P>0.05).The body weight,umbilical arterial blood gas analysis and anesthesia induction in the two groups.There was no significant difference in the time of delivery of the fetus,the time from uterine incision to the time of delivery of the fetus,and the time from peritoneal incision to uterine incision(P>0.05).Conclusion Remifentanil combined with desflurane for general anesthesia in cesarean section can improve the analgesic effect,maternal hemodynamics is stable.recovery time is short,and has no adverse effect on neonatal outcomes.

关 键 词：剖宫产 全身麻醉 瑞芬太尼 地氟烷 胎儿结局 

分 类 号：R971.2[医药卫生—药品]