气管插管全麻在剖宫产中的麻醉分析

目的观察气管插管全麻对剖宫产术中母婴的安全和可行性。方法对196例血凝异常、血小板<60万、椎管内麻醉阻滞失败、椎管畸形等(除术前已有胎儿宫内窘迫)的产妇实行气管插管全麻。诱导:氯胺酮0.3～0.5mg/kg、丙泊酚1～1.5mg/kg、司可林1～1.5mg/kg快速诱导插管,胎儿娩出后静脉给予咪达唑仑2～3mg、芬太尼0.1mg、维库溴胺4mg,根据生命体征吸入<1%的异氟烷维持。分别记录诱导前、中、后产妇BP、P、ECG、SPO2,观察胎儿娩出1、5、10min新生儿Apgar评分。结果麻醉诱导时BP略有下降,插管时略有升高、P有升高、SPO2无明显变化,所有胎儿于5min内娩出,Apgar评分>8分。全麻对母婴无明显影响,胎儿娩出无明显呼吸抑制,且产妇术毕5～10min完全清醒拔管。结论气管插管全麻对剖宫产的母婴安全可靠。

Objective Observation trachea cannula general anesthesia to c-section technique in maternal infant＇s safety and feasibility.Methods Doubts exceptionally,the blood platelet to 196 example bloodin 600,000,neurocanals to anaesthetize hinders the defeat,the neurocanal abnormally and so on（before the technique has in embryo palace poverty-stricken） the parturient woman to implement the trachea cannula general anesthesia.Induction：Ketamine 0.3-0.5mg/kg,third anchors phenol 1-1.5mg/kg,Si Kelin the 1-1.5mg/kg fast induction intubation,after the embryo childbirth leaves,the vein gives the onamot to reach zuo logical sequence 2-3mg,Fentaini 0.1mg,Uygur storehouse bromo-amine 4mg,inhales 1% different fluorine alkane maintenance according to the life symptom.Before,during and after the distinction record induction parturient woman BP,P,ECG,SPO2,observe the embryo childbirth to leave 1min,5min,10min the newborn Apgar grading.Results anaesthesia induction BP slightly has the drop,when the intubation slightly has elevates,P to have elevates,SPO2 to change not obviously,therefore the embryo in 5 minutes in childbirths leaves,Apgar grades the 8 minute.The general anesthesia affects not obviously to the maternal infant,the embryo childbirth leaves not obvious breath to suppress,and the parturient woman technique finishes 5-10 minute completely sober cuppings.Conclusion Trachea cannula general anesthesia to c-section maternal infant safe reliable.