剖宫产术应用丙泊酚复合雷米芬太尼全身麻醉对25例产妇及新生儿的影响

Effect of general anesthesia with propofol combined with remifentanil on 25 parturients and neonates during cesarean section

目的 :探讨剖宫产术应用丙泊酚复合雷米芬太尼全身麻醉对产妇及新生儿的影响。方法 :选取50例剖宫产术产妇,根据不同的麻醉方法分为对照组及研究组各25例,对照组行常规全身麻醉,研究组行丙泊酚复合雷米芬太尼全身麻醉,比较两组产妇血流动力学指标变化、新生儿相关情况及脐血血气指标。结果 :两组麻醉前及拔管后心率及平均动脉压、子宫切开至胎儿娩出时间(U-D)、新生儿氧摄取率(oxygen extraction ratio, ERO_2)、1 min及5 min Apgar评分、动静脉脐血血气比较无统计学差异(P> 0.05),而研究组切皮时的心率及平均动脉压均显著高于对照组,麻醉开始至胎儿娩出时间(I-D)显著低于对照组(P <0.05)。结论 :丙泊酚复合雷米芬太尼对ERO2无明显影响,母体血流动力学及新生儿脐血血气指标稳定,在剖宫产中具有一定的应用价值。

Objective:To explore the effect of general anesthesia with propofol combined with remifentanil on parturients and newborns during cesarean section.Methods:Fifty parturients undergoing cesarean section were divided into a control group and a study group based on their different anesthesia methods.The control group underwent general anesthesia while the study group underwent general anesthesia with propofol and remifentanil.The changes of hemodynamics,neonatal related conditions and umbilical cord blood gas were compared between the two groups.Results:There were no significant differences in heart rate and mean arterial pressure before and after anesthesia,and the time from uterine incision to delivery of the fetus(U-D),neonatal oxygen ratio(ERO 2),Apgar score at 1 min and 5 min and arteriovenous umbilical blood gas between the two groups(P>0.05),however,the heart rate and mean arterial pressure at incision time was significantly longer and the time from the initiation of anesthesia to the delivery of the fetus(I-D)was significantly shorter in the study group than the control group(P<0.05).Conclusion:Propofol combined with remifentanil has no significant effect on neonatal ERO 2.Maternal hemodynamics and neonatal umbilical cord blood gas are stable.It has certain application value in cesarean section.