腰麻联合硬膜外麻醉在再次剖宫产术中的应用观察

Clinical observation on CSEA's application to the second cesarean section surgery

目的:探讨腰麻联合硬膜外麻醉在再次剖宫产术中的安全性及临床效果。方法:对160例需要再次剖宫产的产妇,随机分为腰麻联合硬膜外(CSEA)组和连续硬膜外(CEA)组,每组各80例,观察两组病例的起效时间、麻醉效果、麻醉至胎儿娩出时间、术中产妇生命体征情况、新生儿情况、麻醉并发症及不良反应。结果:CSEA组在麻醉起效时间、麻醉效果、麻醉至胎儿娩出时间均高于CEA组,P<0.05。术中产妇生命体征情况、新生儿情况、麻醉并发症及不良反应无显著差异。结论:CSEA组综合腰麻和硬膜外麻醉的优点,具有起效快,阻滞完善,对产妇呼吸、循环干扰少,母婴安全。腰麻联合硬膜外麻醉用于再次剖宫产是安全可行的。

Objective：To investigate the clinical effects and safety of the combined spinal-epidural anesthesia（CSEA） in the second cesarean section.Methods：160 cases of delivery women with second cesarean section were introduced to use CSEA and continuous epidural anesthesia（CEA）.The two products will be contrasted in the onset time,anesthetic efficacy,Anesthesia to fetal delivery time,Maternal and newborn life signs,adverse reaction,and so on.Results： There is a statistically significant difference（P value 0.05） of the onset time,anesthetic efficacy and the Anesthesia to fetal delivery time.The two groups had no significant adverse reactions about Maternal and newborn life signs,adverse reaction.Conclusions： CSEA combination of spinal anesthesia,as well as the advantages of epidural anesthesia.The advantages are as below： quick-effective,lower-dosage,and perfect-block,lower intervention to cycle and breath,no time limitation,linking the post operative PCA,and so on.CSEA anesthesia is safe,stable and feasible in the second cesarean section.