小剂量腰麻-硬膜外联合阻滞麻醉在高龄剖宫产产妇中的应用效果  

Application of low-dose combined spinal-epidural anesthesia in elderly parturients undergoing cesarean section

作　　者：陈佳青 甘育涛 施勇军 Chen Jiaqing;Gan Yutao;Shi Yongjun(The Yichun Hospital of TCM,Yichun,Jiangxi 336000)

机构地区：[1]宜春市中医院,江西宜春336000

出　　处：《基层医学论坛》2023年第23期38-40,共3页The Medical Forum

摘　　要：目的 探讨小剂量腰麻-硬膜外联合阻滞麻醉在高龄剖宫产产妇中的应用效果。方法 研究对象为宜春市中医院收治的50例高龄剖宫产产妇,选例时间2019年8月—2021年5月,依据随机数字表法将产妇分为对照组和观察组,各25例。对照组产妇接受单纯硬膜外麻醉,观察组产妇在对照组基础上联合小剂量腰麻进行麻醉。对比2组产妇麻醉期间阻滞效果、麻醉情况、t0~t4时生命体征、术后并发症发生情况。结果 麻醉期间,观察组阻滞总优良率高于对照组(P<0.05);2组麻醉至手术时间、手术时间对比,差异无统计学意义(P>0.05);麻醉期间,观察组Bromage评分高于对照组,麻黄碱用量少于对照组(P<0.05);t0~t4时2组心率(heart rate,HR)水平均呈升高—降低—升高的趋势,且t1观察组低于对照组,t3~t4时HR水平观察组高于对照组(P<0.05),而t0、t2时心率(HR)水平2组差异无统计学意义(P>0.05);t0~t4的2组收缩压(sytolic bluod pressure,SBP)水平呈先降低后升高的趋势,且t1~t4时SBP水平观察组均高于对照组(P<0.05),而t0时2组SBP水平差异无统计学意义(P>0.05);t0~t4的2组舒张压(diastolic blood pressure,DBP)水平呈先降低后升高的趋势,且t2~t4时DBP水平观察组高于对照组(P<0.05),而t0、t1时2组DBP水平差异无统计学意义(P>0.05)。结论 高龄剖宫产产妇应用小剂量腰麻-硬膜外联合阻滞麻醉可提高麻醉阻滞效果,减少麻醉药物用量,稳定生命体征。Objective To investigate the effect of low-dose combined spinal-epidural anesthesia in elderly parturients undergoing Cesarean section.Methods 50 cases were selected from the elderly parturients admitted to our hospital from August to 2021.They were divided into control group and observation group,25 cases in each group.The parturient in the control group received simple epidural anesthesia,while the parturient in the observation group received small dose spinal anesthesia on the basis of the control group.Both groups were observed 48 hours after delivery.Comparison of the blocking effect,anesthesia status,vital signs at t0~t4,and postoperative complications between the two groups of parturients during anesthesia.Results During anesthesia,the excellent and good rate of block in the observation group was higher than that in the control group(P<0.05).There was no significant difference between the twogroups in the time fromanesthesia tooperation and operation time(P>0.05).During anesthesia,the Bromage score of the observation group was higher than that of the control group,and the dosage of ephedrine was less than that of the control group(P<0.05).The HR levels of the t0~t4 two groups showed a trend of increasing-decreasing-increasing,and the t1 observation group was lower than the control group,and the t3~t4 observation group was higher than the control group(P<0.05),but there was a difference between the t0 and t2 groups No statistical significance(P>0.05).SBP levels in the t0~t4 two groups decreased and then increased,and the t1~t4 observation group was higher than the control group(P<0.05),but therewas nostatistical difference between the t0 two groups significance(P>0.05).The DBP levels of the t0~t4 two groups decreased and then increased,and the t2~t4 observation group was higher than the control group(P<0.05),while the difference between the t0 and t1 two groups was not statistically significant(P>0.05).Conclusion Low-dose combined spinal-epidural anesthesia can improve the effect of anesthesia,enhance the d

关 键 词：高龄剖宫产 小剂量腰麻-硬膜外联合阻滞麻醉 阻滞效果 生命体征 并发症 

分 类 号：R614.41[医药卫生—麻醉学] R614.42[医药卫生—外科学]