氯胺酮在剖宫产诱导麻醉中的临床疗效  

Clinical effect of ketaminein induced anesthesia for cesarean section

作　　者：施勤[1] 沈卫红[2] 王猛[1] 周洁[1] 李颖 潘云松[2] SHI Qin;SHEN Weihong;WANG Meng;ZHOU Jie;LI Ying;PAN Yunsong(Wuxi Maternal and Child Health Care Hospital,Jiangsu Wuxi 214000,China;Wuxi Second People′s Hospital,Jiangsu Wuxi 214000,China)

机构地区：[1]无锡市妇幼保健院麻醉科,江苏无锡214000 [2]无锡市第二人民医院麻醉科,江苏无锡214000

出　　处：《中国妇幼健康研究》2021年第8期1224-1228,共5页Chinese Journal of Woman and Child Health Research

基　　金：江苏省高校哲学社会科学基金(2017SJB0273)。

摘　　要：目的探讨氯胺酮在剖宫产诱导麻醉中的临床疗效。方法选取2016年5月至2020年8月我院产科收治的80例剖宫产孕产妇为研究对象,以随机数表法分为观察组(40例,采用氯胺酮诱导麻醉)、对照组(40例,采用瑞芬太尼诱导麻醉)。比较两组进入麻醉恢复室(PACU)5min、10min、20min时Ramsay镇静评分(RSS)情况,比较两组组新生儿出生后1min、5min、10min的Apgar评分及两组术后2h、术后4h、术后12h的视觉模拟评分(VAS)情况,统计麻醉相关不良反应发生情况。结果 RSS评分组间比较、时间点比较及交互作用差异均有统计学意义(F组间=11.457,F时间=10.005,F交互=11.342,P<0.05);观察组入PACU 5min、10min及20min RSS评分均低于对照组(t分别为4.502、3.237、3.632,P<0.05)。Apgar评分组间比较、时间点比较及交互作用差异均无统计学意义(P>0.05),两组新生儿出生后1min、5min、10min的Apgar评分比较,差异均无统计学意义(P>0.05)。VAS评分组间比较、时间点比较及交互作用差异均有统计学意义(F组间=10.975,F时间=12.846,F交互=9.837,均P<0.05);观察组术后2h、术后4h、术后12h疼痛VAS评分均低于对照组,差异有统计学意义(t值分别为4.212、4.676、4.122,P<0.05)。两组不良反应发生率对比差异无统计学意义(P>0.05)。结论在剖宫产中实施氯胺酮诱导麻醉效果良好,安全可靠。Objective To explore the clinical efficacy of ketamine in induced anesthesia for cesarean section. Methods A total of 80 cases of pregnant women undergoing cesarean section admitted to the obstetrics department of our hospital from May 2016 to August 2020 were selected as the research objects, and they were divided into the observation group(40 cases, using ketamine to induce anesthesia) and the control group(40 cases, using remifentanil to induce anesthesia) according to the random number table method. The Ramsay sedation score(RSS) at 5 min, 10 min, and 20 min after entering the post-anesthesia care unit(PACU) of the two groups were compared. The Apgar scores at 1 min, 5 min, and 10 min after birth of the two groups of newborns and the visual analogue scale(VAS) scores of the two groups at 2 h, 4 h, and 12 h after the operation were compared. Anesthesia-related adverse reactions were counted. Results The RSS scores differences between groups, time points, and interaction were statistically significant(F=11.457,10.005 and 11.342,respectively, P<0.05). The RSS scores of the control group at 5 min, 10 min and 20 min after entering the PACU were lower than the control group, and the differences were statistically significant(t=4.502,3.237 and 3.632,respectively, P<0.05). There were no significant differences in Apgar scores between the two groups, time points, and interaction effects(P>0.05). Comparisons between the two groups found that there were no statistically significant differences in Apgar scores at 1 min, 5 min, and 10 min after birth(P>0.05). VAS scores comparison between groups, time points and interaction difference were statistically significant(F=10.975,12.846 and 9.837,respectively, P<0.05). VAS scores of the observation group were lower than the control group at 2 h, 4 h and 12 h, and the differences were statistically significant(t=4.212,4.676 and 4.122,respectively, P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conc

关 键 词：剖宫产 氯胺酮 麻醉 疗效 

分 类 号：R714.3[医药卫生—妇产科学]