利多卡因星状神经节阻滞与腰-硬联合麻醉在剖宫产手术中的应用效果分析  

Application effect of stellate ganglion block with lidocaine and combined spinal-epidural anesthesia in cesarean section

作　　者：高月[1] GAO Yue(Department of Anesthesiology,Siping City Central People's Hospital of Jilin Province,Siping 136000,China)

机构地区：[1]四平市中心人民医院麻醉科,吉林四平136000

出　　处：《中国处方药》2025年第7期74-77,共4页Journal of China Prescription Drug

摘　　要：目的分析利多卡因星状神经节阻滞(SGB)与腰麻-硬膜外联合阻滞麻醉(腰-硬联合麻醉)在剖宫产手术中的应用效果。方法选取2021年8月~2024年8月于某院接受剖宫产分娩的孕妇86例,根据分层抽样法分为2组,每组43例。对照组采用腰-硬联合麻醉,观察组接受利多卡因SGB和腰-硬联合麻醉。比较两组不同时间节点的血流动力学指标[收缩压(SBP)、心率(HR)]、应激指标[皮质醇(Cor)、超氧化物歧化酶(SOD)、内皮素(ET)]水平,同时记录两组产妇术中不良反应发生率,比较两组新生儿的血气分析[酸碱度(pH)、血氧分压(PO_(2))、二氧化碳分压(PCO_(2))]水平。结果观察组麻醉10 min后(T_(1))、麻醉20 min后(T_(2))时SBP高于对照组(P<0.05);观察组T_(1)、T_(2)时HR高于对照组,术毕时(T_(3))低于对照组(P<0.05);观察组T_(1)、术后1 h的Cor、SOD低于对照组(P<0.05);观察组T_(1)时ET水平低于对照组(P<0.05);两组术中不良反应发生率比较,差异无统计学意义(P>0.05);两组新生儿pH、PO_(2)、PCO_(2)水平比较,差异无统计学意义(P>0.05)。结论利多卡因SGB的应用,可稳定剖宫产产妇的血流动力学,调节应激指标水平,对产妇、新生儿的安全性均较高。Objective To analyze the application effect of stellate ganglion block(SGB)with lidocaine and combined spinal-epidural anesthesia in cesarean section.Methods A total of 86 pregnant women who underwent cesarean section in the hospital from August 2021 to August 2024 were selected and divided into two groups according to stratified sampling method,with 43 cases in each group.The control group received combined spinal-epidural anesthesia,while the observation group received SGB with lidocaine combined with combined spinal-epidural anesthesia.The hemodynamic indicators[systolic blood pressure(SBP)and heart rate(HR)]and stress indicators[cortisol(Cor),superoxide dismutase(SOD)and endothelin(ET)]at different time points were compared between the two groups.The incidence rates of adverse reactions in the two groups during operation were recorded.Neonatal blood gas indexes[power of hydrogen(pH),partial pressure of oxygen(PO_(2))and partial pressure of carbon dioxide(PCO_(2))]were compared between the two groups.Results The observation group had higher SBP than the control group at 10 min after anesthesia(T_(1))and 20 min after anesthesia(T_(2))(P<0.05).Compared with the control group,the observation group had higher HR at T_(1)and T_(2),and lower HR at the end of operation(T_(3))(P<0.05).At T_(1)and 1 h after operation,Cor and SOD levels in observation group were lower than those in the control group(P<0.05).At T_(1),ET level in the observation group was lower than that in the control group(P<0.05).The two groups showed no statistically significant differences in the incidence of intraoperative adverse reactions and neonatal pH,PO_(2)and PCO_(2)(P>0.05).Conclusion SGB with lidocaine can stabilize hemodynamics in delivery women undergoing cesarean section and regulate their stress index levels,with high safety for both mdelivery women and neonates.

关 键 词：利多卡因 星状神经节阻滞 腰-硬联合麻醉 剖宫产 

分 类 号：R614[医药卫生—麻醉学]