摘要
目的:探讨小剂量预注射联合手术中持续泵注甲氧明对剖宫产产妇血流动力学及新生儿血气指标的影响。方法:选择在腰麻硬膜外联合阻滞下行剖宫产术产妇90例,随机分为3组,3组均采取蛛网膜下腔注射布比卡因麻醉,M_1组于蛛网膜下腔注入药物时静脉注射甲氧明2 mg后、以100μg/min持续泵注甲氧明至术毕,M_2组当收缩压(SBP)降低基础值的20%时、单次静脉注射甲氧明3 mg,C组当SBP降低基础值的20%时、单次静脉注射麻黄碱10 mg;比较各组产妇入室时(T_0)、麻醉后5 min(T_1)、麻醉后10 min(T_2)、麻醉后30 min(T_3)、术毕(T_4)SBP、舒张压(DBP)及心率(HR)的变化,检测各组新生儿脐动脉血pH值、氧分压(PO_2)、二氧化碳分压(PCO_2)及碱剩余(BE)。结果:与M_1组比较,T_1时点M_2组和C组SBP、DBP显著降低(P<0.05),T_2时点M_2组HR显著降低,C组显著增高(P<0.05);C组新生儿脐动脉血气pH值和BE值显著低于M_1组和M_2组(P<0.05)。结论:预注射联合术中持续泵注甲氧明可使腰硬联合阻滞下剖宫产产妇血流动力学更稳定,胎儿酸碱平衡更稳定。
Objective： To investigate the effect of pre-infusion combined with continuous pump injec- tion of metoxamine during cesarean section on maternal hemodynamies and neonatal blood gas index. Methods： Selecting 90 maternal cases to perform spinal-epidural anesthesia in cesarean section, they were randomly divided into 3 groups; three groups were injected with bupivacaine for anesthesia in subarachnoid space. M1 group subarachnoid space injection was combined with injection of intravenous 2 mg methoxamine after 100 g/min continuous infusion until the end of operation; concerning M2 group, when the systolic blood pressure （SBP） below 20%, a single time intravenous dose of methoxamine 3 mg was injected; concerning C group, when the systolic blood pressure （SBP） was below 20%, a single time intravenous ephedrine 10 mg was injected. Comparing time admitting to the surgery T0, 5 rain after anesthesia （ T1 ）, 10 rain after anesthesia （ T2 ） , 30 rain after anesthesia （ T3 ） and the end of operation （T4 ）, systolic blood pressure （ SBP）, diastolic blood pressure （DBP） and heart rate （HR） changes; testing neonatal umbilical cord arterial blood gas values, PO2, PCO2 and BE. Results： Comparing with M1 group, M2 group and C group at T1 showed significant decrease of SBP and DBP （P 〈 0.05 ） ; at T2, M2 group showed significant HR decrease, while C group showed obvious increase （ P 〈 0.05 ） ; C group neonatal umbilical cord arterial blood pH value and BE value was significantly lower than that of M1 group and M2 group （P 〈 0.05 ）. Conclusion： Pre-injection combined with continuous pump injection of metoxamine can make the hemodynamics more stable and fetal acid-base balance is more stable.
出处
《贵州医科大学学报》
CAS
2017年第1期109-112,共4页
Journal of Guizhou Medical University
基金
中山市科技局科学事业项目(2015B1285)
关键词
甲氧明
麻醉
剖宫产术
血流动力学
血气分析
metoxamine
anesthesia
cesarean section
hemodynamics
blood gas analysis
