不同椎管内麻醉在急诊高龄剖宫产术产妇中的应用效果  

Application Effect of Different Spinal Anesthesia in Elderly Women Undergoing Emergency Cesarean Section

作　　者：佟泉威 TONG Quanwei(Dandong Central Hospital,Dandong 118000,China)

机构地区：[1]丹东市中心医院,辽宁丹东118000

出　　处：《中国医药指南》2023年第12期92-94,共3页Guide of China Medicine

摘　　要：目的观察给予急诊高龄剖宫产术产妇不同椎管内麻醉的效果。方法本次试验将我院收治的50例急诊高龄剖宫产术产妇作为研究对象,经电脑随机分组,各25例,观察组采取腰硬联合麻醉,做好术前准备工作,消毒铺巾工作等,于L_(2)~L_(3)间隙展开腰硬联合穿刺,采取玻璃注射器缓慢进针,注入氯化钠溶液,将腰麻针置入,刺破硬椎膜和蛛网膜,注入布比卡因,固定好引导产妇采取平卧位,将麻醉平面控制在T_(6)~S_(1),于硬膜外注入利多卡因,每隔半个小时追加一次利多卡因,对照组采取连续硬膜外麻醉,指导产妇采取左侧卧位,常规消毒产妇皮肤,于产妇L_(1)~L_(2)椎间隙展开硬膜外穿刺,注入利多卡因溶液,将麻醉平面控制在T_(6)~S_(1),于硬膜外注入利多卡因,每隔半个小时追加一次利多卡因,对比两组麻醉效果。结果术后1 h,组间心率、平均动脉压、体温水平对比,无明显差异(P>0.05);术后24 h,观察组比对照组术后生命体征表现更稳定(P<0.05),术后24 h,观察组比对照组术后生活质量评分更高(P<0.05);组间并发症发生率对比,观察组更低(P<0.05)。观察组比对照组麻醉起效时间、痛觉消失时间均更短(P<0.05)。结论给予急诊高龄剖宫产术产妇腰硬联合麻醉,能够缩短麻醉起效时间,能够稳定产妇术后生命体征,提升产妇生活质量。Objective To observe the effect of different intraspinal anesthesia on elderly women undergoing emergency caesarean section.Methods In this study,50 cases of emergency aged women who underwent cesarean section in our hospital were selected as the research object,and 25 cases were randomly grouped by computer.The observation group received combined lumbar and epidural anesthesia,and made preoperative preparation,disinfection and towel laying,etc.The joint epidural puncture was performed at the L_(2)-L_(3) interval,the needle was slowly injected with sodium chloride solution with a glass syringe,the lumbar anesthesia needle was inserted,the dural membrane and arachnoid membrane were punctured,bupivacaine was injected,the parturient was fixed and guided to take a supine position,the anesthesia plane was controlled at T_(6)-S_(1),the epidural lidocaine was injected,and lidocaine was added every half hour.The control group was given continuous epidural anesthesia,the parturients were instructed to take the left lateral position,the parturients'skin was routinely disinfected,epidural puncture was performed in the intervertebral space of L_(1)-L_(2),lidocaine solution was injected,the anesthesia plane was controlled at T_(6)-S_(1),lidocaine was injected into the epidural,and lidocaine was added every half hour,and the anesthetic effect was compared between the two groups.Results One hour after operation,there were no significant differences in heart rate,mean arterial pressure and body temperature among groups(P>0.05).24 hours after surgery,the observation group was more stable than the control group(P<0.05),24 hours after surgery,the observation group was higher than the control group postoperative quality of life score(P<0.05);The incidence of complications in the observation group was lower than the control group(P<0.05).The onset time of anesthesia and the disappearance time of pain were shorter in the observation group than in the control group(P<0.05).Conclusion The combination of lumbar and epidural anesthesia ca

关 键 词：急诊 高龄剖宫产术产妇 连续硬膜外麻醉 腰硬联合麻醉 

分 类 号：R719.8[医药卫生—妇产科学] R614[医药卫生—临床医学]