不同剂量瑞芬太尼在先兆子痫产妇剖宫产麻醉中的安全性研究  

Safety of different doses of remifentanil in cesarean section anesthesia of pregnant women with preeclampsia

作　　者：孟红伟[1] MENG Hong-wei(Operating room,Anshan Women’s and Children’s Hospital,Anshan 114000,China)

机构地区：[1]鞍山市妇儿医院手术室,114000

出　　处：《中国实用医药》2021年第35期131-134,共4页China Practical Medicine

摘　　要：目的分析不同剂量瑞芬太尼在先兆子痫产妇剖宫产麻醉中的安全性。方法80例先兆子痫产妇,以随机数字表法分为对照组和观察组,各40例。对照组给予0.5μg/kg瑞芬太尼进行术中麻醉,观察组给予1.0μg/kg瑞芬太尼进行术中麻醉。比较两组产妇血压、心率变化及心血管反应。结果麻醉前及胎儿娩出时,两组血压、心率水平对比,差异无统计学意义(P>0.05);插管及切皮时,观察组血压及心率水平均低于对照组,差异具有统计学意义(P<0.05)。观察组诱导1 min甲肾上腺素(500.0±133.2)pg/ml、肾上腺素(65.9±26.5)pg/ml及分娩中去甲肾上腺素(685.6±144.0)pg/ml、肾上腺素(165.6±30.2)pg/ml均低于对照组的(565.5±146.6)、(755.0±127.4)、(78.8±24.1)、(183.2±40.8)pg/ml,差异有统计学意义(P<0.05)。结论瑞芬太尼应用在先兆子痫剖宫产产妇麻醉中对其心血管保护效果好,以0.5μg/kg的用药剂量可充分满足麻醉要求,且安全性高。Objective To analyze the safety of different doses of remifentanil in cesarean section anesthesia of pregnant women with preeclampsia.Methods 80 pregnant women with preeclampsia were randomly divided into control group and observation group,with 40 cases in each group.Women in the control group were administered with 0.5μg/kg of remifentanil for intraoperative anesthesia,and women in the observation group were administered with 1.0μg/kg of remifentanil for intraoperative anesthesia.The changes of blood pressure and heart rate,and cardiovascular response were compared between the two groups.Results Before anesthesia and during fetal delivery,differences in blood pressure and heart rate between the two groups were not statistically significant(P>0.05).During intubation and skin cutting,blood pressure and heart rate of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).After 1 min of induction,the observation group had norepinephrine of(500.0±133.2)pg/ml,epinephrine of(65.9±26.5)pg/ml;and during delivery,the observation group had norepinephrine of(685.6±144.0)pg/ml,epinephrine of(165.6±30.2)pg/ml.Those were lower than(565.5±146.6),(755.0±127.4),(78.8±24.1),(183.2±40.8)pg/ml of the control group,respectively.The differences were statistically significant(P<0.05).Conclusion The application of remifentanil in cesarean section anesthesia of pregnant women with preeclampsia has a good cardiovascular protective effect.The dosage of 0.5μg/kg can fully meet the requirements of anesthesia,with a high safety.

关 键 词：先兆子痫 剖宫产 麻醉 瑞芬太尼 心血管反应 

分 类 号：R614[医药卫生—麻醉学]