聚明胶肽对联合硬膜外—腰麻下剖宫产术中恶心呕吐的预防

Acute Hypervolume Hemodilution with Polygeline for Prevention the Cesarean Section Patient's Nausea and Vomiting under Combined Spinal-Epidural Anesthesia

目的观察聚明胶肽对联合硬膜外—腰麻下剖宫产术中恶心呕吐的预防效果。方法80例初产妇随机分为两组,A组为聚明胶肽;B组为复方氯化钠。两组患者分别于腰麻前30 min内静脉输注聚明胶肽、复方氯化钠500 ml,均采用布比卡因(0.5%布比卡因3 ml+10%葡萄糖1 ml)重比重液3 ml行腰麻。腰麻后低血压持续超过3min者,静脉滴注麻黄素10 mg,比较两组腰麻后低血压、恶心、呕吐等的发生率及麻黄素应用率。结果A组低血压、恶心、呕吐的发生率、麻黄素应用率均明显低于B组(P<0.05)。结论聚明胶肽急性高容量血液稀释可有效防治联合硬膜外—腰麻下剖宫产术中恶心呕吐的发生。

Objective To investigate the effect of acute hypervolume hemodilution （AHH） with polygeline on the cesarean section patient＇s nausea and vomiting under combined spinal- epidural anesthesia. Methods 80 cases of primiparas aged 20 - 35 and weighed 57 - 86 kg undergoing cesarean section under combined spinal - epidural anesthesia were randomized into 2 groups （n =40 each）. Within 30 minutes prespinal anesthesia, the patients in group A （n = 40）received 500 ml of polygeline, those in group B （n =40） 500 ml of compound sodium chloride. Spinal anesthesia was performed with bupivacaine hyperbaric soloution in all patients. Hypotension lasting 〉 3 minutes was treated with Ⅳ bolous of ephedrine 10mg. The incidences of spinal hypotension, nausea and vomiting and the use of ephedrine were compared in the two groups. Results The incidences of spinal hypotension, nausea and vomiting and the administration of ephedrine in group A was significantly lower than those in group B （P 〈0.05）. Conclusions the AHH with polygeline can effectively prevent the cesarean section patient＇s nausea and vomiting under combined spinalepidural anesthesia.