摘要
目的探讨不同体位剖宫产术对等比重布比卡因腰硬联合麻醉（CSEA）起效时间及麻醉平面的影响。方法选择医院妇产科2014年4月至2015年10月收治的行剖宫产产妇86例,按随机数字表法将产妇分为对照组和研究组,各43例。两组产妇均采用CSEA法麻醉,对照组产妇采用仰卧位,研究组产妇采用坐位。观察两组产妇的麻醉效果,记录麻醉起效时间和麻黄碱的用量、阻滞完善时间和麻醉平面;观察产妇术后的不良反应,统计产妇术中血流动力学相关指标,如动脉舒张压（DAP）、动脉收缩压（SAP）、心率（HR）及血氧饱和度（SpO_2）的变化。结果对照组产妇的麻醉总有效率为65.12%,明显低于研究组的86.05%（P〈0.05）;与对照组相比,研究组产妇的阻滞完善时间、Bromage评分Ⅲ级时间和麻黄碱用量均明显下降（P〈0.05）,两组产妇的最高麻醉平面胸部位置比较,差异无统计学意义（P〉0.05）;除SpO_2外,研究组产妇的DAP,SAP,HR水平均显著低于对照组（P〈0.05）;研究组产妇的并发症发生率为13.95%,显著低于对照组的32.56%（χ^2=4.170,P=0.041〈0.05）。结论相对于仰卧位,行剖宫产产妇采用坐位等比重布比卡因CSEA可缩短麻醉起效时间,改善产妇的麻醉平面及血流动力学情况,减少并发症的发生率,对于改善母婴结局有重要意义。
Objective To investigate the influence of different positions on onset time of anesthesia and block plane of isobaric bupivacaine for caesarean section with combined spinal- eqidural analgesia（ CSEA）. Methods 86 cases of maternal with cesarean delivery from April 2014 to October 2015 were seleceted and divided into the control group and research group according to the stochastic indicator method,43 cases in each group. Both groups were treated with CSEA,the control group used the supine position,while the research group used the seat position. The anesthesia effect of two groups of maternal was observed,and anesthesia effect time and the dosage of ephedrine were recorded in detail. At the same time,block perfect time and anesthesia plane were recorded. Adverse reactions were observed,in addition,maternal hemodynamics indicators,such as artery diastolic pressure（ DAP）,arterial systolic pressure（ SAP）,heart rate（ HR） and the change of blood oxygen saturation（ SpO_2）,were analyzed. Results The total effective rate of anesthesia in the control group was 65. 12%,which was significantly lower than 86. 05% of the research group（ P 0. 05）; compared with the control group,the block perfect time,Bromage Ⅲ score and methamphetamine using of the research group of maternal declined obviously,and the differences were statistically significant（ P〈0. 05）. But the difference of the highest maternal anesthesia plane chest between two groups was no statistical significance（ P〉0. 05）; except for the SpO_2,the DAP,SAP and HR levels of research group of maternal were significantly lower than control group（ P〈0. 05）; Team of maternal complications was 13. 95%,which was significantly lower than 32. 56% of the control group（ χ^2 = 4. 170,P = 0. 041〈0. 05）. Conclusion Compared with the supine position,the maternal with cesarean delivery used the proportion of cloth such as seat than paid CSEA anesthesia effect can shorten the time,improve maternal anesthesia plane and hemodynamic situation,at the same time it also can reduce the incidence of complications,which is of great significance for improving maternal and infant outcomes.
出处
《中国药业》
CAS
2016年第14期26-29,共4页
China Pharmaceuticals
基金
广东省广州市花都区科技计划项目
项目编号:12-HDWS-017
关键词
体位
剖宫产
等比重
布比卡因
腰硬联合麻醉
position
cesareansection
isobaric
bupivacaine
combined spinal-epidural anesthesia
