摘要
目的探讨高龄剖宫产手术中采取腰硬膜外联合麻醉的应用价值。方法随机抽取2016年1月-2018年1月期间60例高龄剖宫产患者,按照随机数表法分为联合组与持续组各30例。持续组患者采取持续硬膜外麻醉方案处理,而联合组则采取腰硬膜外联合麻醉方案处理。测定麻醉前、麻醉后、手术牵拉反应时两组患者心率、收缩压、舒张压情况,并记录麻醉效果(起效时间、镇痛维持时间)、不良反应情况。结果两组患者在麻醉前心率、收缩压、舒张压对比差异无统计学意义(P>0.05),麻醉后与手术牵拉反应时联合组患者收缩压与舒张压低于持续组,差异有统计学意义(P<0.05);联合组在手术牵拉反应时心率低于持续组,差异有统计学意义(P<0.05);联合组患者麻醉起效时间短于持续组,且镇痛维持时间长于持续组,差异均有统计学意义(P<0.05);联合组不良反应总发生率低于持续组,差异有统计学意义(P<0.05)。结论腰硬膜外联合麻醉应用于高龄剖宫产产妇具有较高的安全性,且麻醉起效时间更短,镇痛维持时间更长,值得借鉴。
Objective To investigate the application of lumbar epidural combined anesthesia in cesarean section. Methods 60 elderly patients with cesarean section from January 2016 to January 2018 were selected and divided into 30 groups according to the random number table. The patients in the continuous group were treated with a continuous epidural anesthesia protocol, while the combined group was treated with a combined lumbar epidural anesthesia protocol. The heart rate, systolic blood pressure, and diastolic blood pressure of the two groups were measured before anesthesia, after anesthesia, and during the traction response. The anesthetic effects（onset time, analgesic duration）and adverse reactions were recorded.Results There was no significant difference in heart rate, systolic blood pressure, and diastolic pressure between the two groups before and after anesthesia（P〈0.05）. There was a significant difference between systolic blood pressure and diastolic blood pressure and continuous group in the combined group after anesthesia and surgical pulling（P〈0.05）.At the same time, the heart rate was significantly different from the continuous group in the traction response of the combined group（P〈0.05）; the onset time of anesthesia in the combined group was significantly shorter than the continuous group（P〈0.05）, and the duration of analgesia was significantly longer than continuous Group（P〈0.05）; The total incidence of adverse reactions in the combined group was significantly lower than the continuous group（P〈0.05）. Conclusions The combined use of epidural and epidural anesthesia for the elderly in cesarean section had a higher safety, and the onset time of anesthesia was shorter and the duration of analgesia was longer, which was worth learning from.
作者
徐连生
Xu Liansheng(Department of Anesthesiology,The First People＇s Hospital of Yibin City,Yibin 644000,China)
出处
《中国病案》
2018年第11期81-83,共3页
Chinese Medical Record
关键词
高龄
剖宫产
腰硬膜外联合麻醉
麻醉效果
血压
Senior age
Cesarean section
Combined lumbar epidural anesthesia
Anesthetic effect
Blood pressure
