急诊剖宫产应用腰麻-硬膜外联合麻醉40例效果评价

Efficacy evaluation of combined spinal-epidural anesthesia in 40 cases with emergency cesarean section

目的评价腰麻-硬膜外联合麻醉在急诊剖宫产中的应用效果。方法选择80例急诊剖宫产、ASA分级为Ⅰ～Ⅱ级、单胎足月妊娠产妇,随机分为两组,每组40例。Ⅰ组采用腰麻-硬膜外联合麻醉(CSEA),Ⅱ组(对照组)采用连续硬膜外麻醉(EA)。对比分析两组术中血流动力学变化、麻醉起效时间及效果、新生儿娩出1min和5min的Apgar评分、麻醉合并症及不良反应。结果两组血流动力学组间和组内比较差异均无统计学意义(P>0.05);起效时间Ⅰ组比Ⅱ组短(P<0.05);Ⅰ组麻醉效果优于Ⅱ组(P<0.01);新生儿娩出1min和5min的Apgar评分两组比较差异均无统计学意义(P>0.05);两组间合并症及不良反应发生率比较差异均无统计学意义(P>0.05)。结论CSEA起效快,肌肉松弛好,麻醉效果确切,更适于急诊剖宫产手术麻醉。

Objective To evaluate the application efficacy of combined spinal-epidural anesthesia (CSEA)in emergency cesarean section.Methods Eighty cases of emergency cesarean section with ASA Ⅰ～Ⅱ grade single-fetus mature pregnant women were randomized into two groups with 40 cases each.Group Ⅰ received CSEA and group Ⅱ(control group)received EA.The hemodynamic changes,the onset time and effect of anesthesia,the Apgar score of fetus delivered after one minute and five minutes,the complications and adverse reactions of anesthesia were recorded during each operation.Results No significant differences were observed in hemodynamic changes between two groups (P>0.05);the onset time of group Ⅰ was significantly shorter than that in group Ⅱ(P<0.05);the anesthesia effect was considered significantly better in group Ⅰ than that in group Ⅱ(P<0.01);in newborns delivered after one minute and five minute,the differences of Apgar scores were not significant (P>0.05);the incidence of complications and adverse reactions in the two groups were not significant (P>0.05).Conclusion CSEA is a reliable,titratable technique which provides more rapid onset of analgesia,stable hemodynamics,and positive muscle relaxation results,and shortens fetus delivery time,so it is more suitable for emergency cesarean section.