腰麻联合硬膜外麻醉在剖宫产术中的应用

Spinal anesthesia combined epidural anesthesia application in cesarean section

目的观察腰麻联合硬膜外麻醉在剖宫产术中的应用效果。方法将240例足月妊娠、拟接受剖宫产术的健康临产妇随机分为观察组及对照组各120例,对照组采用硬膜外阻滞麻醉,观察组采用腰麻-硬膜外联合麻醉。结果观察组的心率、局麻药用量、麻醉阻滞完善所需时间、麻醉恢复时间、不良反应发生率、阻滞不全发生率明显少于对照组(P<0.05);两组患者平均动脉压、最高麻醉平面、新生儿Apgar评分差异无统计学意义(P>0.05);观察组麻醉效果优良率为100.0%,对照组为99.17%,差异无统计学意义(P>0.05),但观察组优为96.67%,明显高于对照组的47.5%(P<0.05)。结论CSEA具有起效快、用药量少、镇痛完全、阻滞完善、肌松满意、对循环、呼吸干扰相对较小、并发症少、不受时间限制等优点,更有利于母婴安全,是一种具有临床推广价值的麻醉方法。

Objective Observe anesthesia combined epidural anesthesia application in cesarean section effect. Methods 240 cases of full-term pregnancy, acceptance cesarean section health mothers were randomly divided into clinical ob- server group and control group in our hospital, control group patients were used epidural anesthesia, observer group pa- tients were used CESA. Results Observer Group patient＇s heart rate, the amount of local anesthetics, narcotic perfect time lag group, anesthesia time, the incidence of adverse reactions, incomplete block were significantly less than the con- trol group（P〈0. 05）. Two groups of patient＇s mean arterial pressure, the highest plane of narcotic （can be reached T6）, neonatal Apgar score there was no significant difference（P〉0.05）, Observer Group patient＇s narcotic effect was 100.0 good, control group was 99.17%, there was no significant difference（P〉0. 05）,observer Group excellent was 96.67%, significantly higher than control group＇s 47.5% （P〈0.05）. Conclusion CSEA has advantages of simple, quick effect, use less pain completely block sound satisfied with the muscle relaxant, on the circulatory, respiratory disturbance is rela- tively small, few complications, no time limit, etc. , more conducive to maternal and child safety, is a reliable method to promote the value of the narcotic.