心脏病孕妇急诊剖宫产的麻醉处理

Anesthesia for pregnant women with cardiopathy undergoing emergency caesarean operation

目的探讨心脏病孕妇急诊剖宫产的麻醉处理。方法2001年1月至2005年12月,65名心脏病孕妇在我院实施急诊剖宫产,59例接受连续硬膜外麻醉,6例接受全身麻醉。观察不同的麻醉方法对孕妇血压、心率、血氧饱和度及新生儿的影响。结果连续硬膜外麻醉对心脏病孕妇急诊剖宫产生命体征影响较小,同期新生儿Apgar评分较高;全麻对患者影响相对较大,同期新生儿Apgar评分相对较低。结论连续硬膜外麻醉是心脏病孕妇急诊剖宫产中相对较好的麻醉方法。

Objective To explore the appropriate anesthesia management for the pregnant women with cardiopathy undergoing emergency caesarean operation.Methods Sixty-five pregnant women with cardiopathy undergoing emergency caesarean operation from Jan 2001 to Dec 2005,59 of which were given continuous epidural anesthesia(EA),and 6 of which were given general anesthesia(GA).The blood pressure(BP),heart rate(HR),pulse oxygen saturation(SpO2),ECG,and liquid amount of discharge & intake of the pregnant women and the Apgar scores of the newborns were monitored.Results The operations were successfully completed upon the patients.The values of BP and HR at different time points after operation of the EA group were all significantly lower than those of the GA group(P<0.05 or <0.01).There were no significant differences in SpO2 at different time points between the 2 groups.The Apgar scores of the newborns 0 and 1 min after delivery of the EA group were 7.9±1.0,8.9±0.8,and 9.7±0.5 respectively,all significantly higher than those of the GA group(4.5±1.0 and 5.7±1.1 respectively,both P<0.01),however,the Apgar score 5 min after delivery of the EA group was 9.7±0.5,not significantly different from that of the GA group(9.4±0.6).Conclusion With less impact on the circulation,EA is the better anesthesia to the pregnant women with cardiopathy who undergo emergency caesarean operation.