两种不同麻醉方法对剖宫产术中血压的影响

Study on the effect of two kind of anaesthesia method on blood pressure during cesarean operation

目的探讨两种不同麻醉方法对剖宫产术中血压的影响,并提出针对性的预防及护理措施。方法选择择期的ASA Ⅰ期实行腰-硬联合麻醉和单纯硬膜外麻醉的剖宫产产妇各50例,对两种麻醉方法在麻醉手术期间引起的低血压进行比较分析。结果麻醉后腰-硬联合麻醉组,血压下降34例(34／50 68％),且在给药后血压即开始下降,3-5 min下降最低,15-20 min恢复到术前水平,收缩压最低者低于8.00kPa;硬膜外麻醉组,血压下降12例(12／50 24％),在给药后15-20 min血压下降最显著;麻醉后血压下降,腰-硬联合麻醉组比硬膜外麻醉组显著增多(P<0.01)。结论两种麻醉方法均可导致血压下降,但腰-硬联合麻醉组明显多于单纯硬膜外麻醉组,因此应重视术前探视、随时准备急救用物和急救药物,常规鼻导管吸氧,早期开放静脉通道,密切观察病情,麻醉后采用左侧倾斜30的体位,使产妇能顺利度过麻醉手术期间的低血压这一关。

Objective To study the effect of two kind of peridural method on blood pressure during cesarean operation, and to put forth related nursing and preventive measurement. Method 50 cases patients with cesarean operation and ASA phase I with combined lumber peridural anaesthesia and single anaesthesia were selected as target. The Iower blood pressure caused by the two kinds of anaesthesia method during anaesthesia operation period were ob-served and analyzed. Resnlt The blood pressure was reduced in 34 cases patients with lumber peridural anaesthesia group after injection of anaesthetic. Account for 68%. The reduction in blood pressure occurred 3-5 minutes after injection of anaesthetic. 15-20 minutes recovered to preoperative Ievel. The lowest contractive pressure was 8. 00 Kpa. 12 cases patients in peridural anaesthesia group observed reduced blood pressure, account for 24%. The re-markable reduction in blood pressure occurred 15-20 minutes after injection anaesthetic. The reduction in blood pressure in combined lumber peridural anaesthesia group is higher than that in peridural anaesthesia group (P< 0. 01). Conclusion The reduction in blood pressure will be induced by the two kinds of anaesthesia method. The reduction in blood pressure in combined lumber peridural anaesthesia group is higher than that of peridural anaesthesia group.