不同麻醉方式应用于剖宫产术的效果观察

Therapeutic observation of different ways of anesthesia in cesarean section

目的探讨腰麻一硬膜外联合麻醉(CSEA)与单纯硬膜外麻醉(EA)在剖宫产术中的效果及副作用。方法选择ASAⅠ、Ⅱ级剖宫产孕妇100例,随机分为CSEA组和EA两组,每组50例,观察比较两组麻醉起效时间、手术时间、胎儿娩出时间、新生儿Apgar评分、Bromage评分和产妇不良反应的发生情况。结果 CSEA组产妇的麻醉起效时间、手术时间和麻醉至胎儿娩出时间明显短于EA组(P<0.05,P<0.01),CSEA组产妇的Bromage评分明显高于EA组(P<0.01);两组新生儿Apgar评分无明显差别(P>0.05);平均动脉压、脉搏血氧饱和度及其余不良反应的发生例数两组比较无明显差别。结论腰-硬联合麻醉的麻醉平面易控制,用于子宫下段剖宫产手术镇痛效果好,手术及胎儿娩出时间短,母婴安全度高,是一种安全有效的麻醉方法。

Objective To compare effects and side effects of combined spinal epidural anesthesia（CSEA） and epidural anesthesia（EA）in cesarean section. Methods A total of 100 women with ASA levels Ⅰ to Ⅱ cesarean section were chosen and equally randomized into CSEA group and EA group.Onset time of anesthesia,surgery duration,childbirth time,neonatal Apgar score,Bromage score and maternal adverse events of the two groups were studied.Results Onset time of anesthesia,surgery duration and childbirth time of the CSEA group were significantly shorter than those of the EA group（P0.05,P0.01）.Neonatal Apgar scores of both groups showed no obvious differences（P0.05）.There were no significant differences between the two groups as to mean arterial pressure,pulse and blood oxygen saturation and adverse events Conclusion CSEA is easy to operate and has better analgesic effect in lower uterine segment cesarean section with shorter surgery duration and childbirth time.It brings more safety to both the mother and infant,thus it is a safe and effective method of anesthesia.