摘要
目的了解剖宫产手术中单纯硬膜外麻醉(EA)、腰麻-硬膜外联合麻醉(CSEA)和静脉麻醉(IA)的临床效果。方法急诊剖宫产手术180例,随机分为3组,A组为单纯硬膜外麻醉,B组为腰麻-硬膜外联合麻醉,C组为静脉麻醉。观察麻醉前、麻醉后(5,10,30 min)术毕、术后2 h的血压、心率、血氧饱和度,记录麻醉效果和起效时间、Bromage评分、术中、术后不良反应以及新生儿Apgar评分。结果 3组产妇在血压、心率、血氧饱和度、新生儿Apgar评分和不良反应差异无统计学意义(P>0.05),麻醉效果满意率、麻醉起效时间和Bromage评分差异有统计学意义(P<0.05)。结论 EA用于剖宫产手术存在麻醉诱导时间长、骶神经阻滞不完善、特别是膀胱腹膜反折处疼痛以及肌松欠佳等缺点,新生儿Apgar评分与其他两组相比略有偏低,但差异无统计学意义(P>0.05);IA用于剖宫产对新生儿安全无明显影响;选用CSEA较佳,操作方便,麻醉平面易控制,成功率高,且费用少,可视为剖宫产术的首选麻醉方法。
Objective To understand the clinical effects of caesarean section with epidural anesthesia（EA）,spinal anesthesia-epidural anesthesia（CSEA） and intravenous anesthesia（IA）.Methods 180 cases of emergency cesarean section were randomly divided into 3 groups,with A group treated by pure epidural anesthesia,B group by spinal anesthesia-epidural anesthesia,and C group by intravenous anesthesia.Observed the intraoperative mean arterial pressure,heart rate,oxygen saturation;recorded the onset time of narcotic effect Bromage score,intraoperative and postoperative adverse events and neonatal Apgar score.Results There were no significant difference in mean arterial blood pressure,heart rate,oxygen saturation,neonatal Apgar scores and adverse reactions between the three groups was no（P0.05）.There were statistics significance in anesthesia satisfaction rate,anesthesia onset time and the Bromage score（P0.05）.Conclusion EA induction of anesthesia for cesarean section has disadvantages such as sacral nerve block imperfect,especially the bladder peritoneal fold at pain,poor muscle relaxation,as well as the shortcomings of a long induction time.Neonatal Apgar score was slightly low compared with the other two groups,but this had no statistical significance（P0.05）.IA for the safety of cesarean section had no significant effect on the newborn.The CSEA is a better,convenient operation with anesthesia plane easy to control,which has a high success rate,and less cost,so can be regarded as the preferred cesarean section anesthesia.
出处
《安徽医学》
2011年第6期765-767,共3页
Anhui Medical Journal
关键词
硬膜外麻醉
腰麻-硬膜外联合麻醉
静脉麻醉
Epidural anesthesia
Spinal anesthesia-epidural anesthesia
Intravenous anesthesia
