硬膜外阻滞侧卧位及辅助药对脉搏血氧饱和度的影响

Effects of Epidwral Block Latecal Position and Supplementary Drugs on SpO2

４０例侧卧位硬膜外阻滞下病人随机分成哌氟组及安定组，观察其硬膜外阻滞后、侧卧位后及辅助用药后ＳｐＯ２变化。结果：硬膜外阻滞后其ＳｐＯ２有下降趋势，侧卧位后ＳｐＯ２下降明显（Ｐ＜０．０５），应用辅助用药后其ＳｐＯ２下降非常明显（Ｐ＜０．０１）。其低氧血症占总例数的５５％，哌氟组ＳｐＯ２下降时间比安定组长，对呼吸抑制较安定组明显，但两组低氧血症总例数无明显差异（Ｐ＞０．０５），表明本麻醉方法呼吸抑制明显。低氧血症之原因是硬膜外阻滞、侧卧位对呼吸功能的影响和安定、哌替啶抑制呼吸复合作用的结果，其低氧血症在面罩Ｆｉｏ≥５０％给氧下迅速缓解。应用本麻醉方法时建议常规给病人供氧，以保证病人的氧合。

SpO2 was monitored in 40 pafients under epidural block and lateral position,supplemented with pethidinedroperidol(GⅠ)or diagepam(G Ⅱ). Results show that SpO2 tended to drop somewhat after onset of epiduralblock,and dropped further in lateral position. (P<0.05).Dropping of SpO2 was further accentuated atfer adminis-tration of supplementary drugs. Hypoxemia occured in 55%of cases,and was relatively feverer and lasting longer inG Ⅰ than that in G Ⅱ. It is supposed that the hypoxesnia was the result of combincd offects of epidural block. later-al position and supplementary drugs, but might be relieved by O2 inhalation. Thus, O2 administered by means ofVenturi mask is recommanded routinely in above mentioned situations to improve oxygenation.