利多卡因联合芬太尼在剖宫产手术硬膜外麻醉中的效果研究

Clinical effect of lidocaine combined with fentanyl in the epidural anesthesia for the caesarean operation

目的观察两种不同硬膜外麻醉方法在剖宫产手术硬膜外麻醉的临床效果。方法回顾性分析2011年10月至2013年9月在广西医科大学第四附属医院(柳州市工人医院)行剖宫产手术的300例产妇的临床资料,以不同硬膜外麻醉方法分为观察组和对照组,观察组(180例)采用利多卡因联合芬太尼;对照组(120例)采用单纯利多卡因,观察两组麻醉效果,包括阻滞有效时间、全程麻药用量、疼痛消失时间、不良反应发生情况、新生儿Apgar评分。结果观察组疼痛消失快、阻滞有效时间长、全程麻药用量少,优于对照组(P<0.05);两组间1min和5min的新生儿Apgar评分、不良反应的发生率比较,差异无统计学意义(P>0.05)。结论在剖宫产手术硬膜外麻醉中利多卡因联合芬太尼比单纯使用利多卡因更安全、有效。

Objective To observe the clinical effect of two different epidural anesthesia in the caesarean operation. Methods The clinical data of the 300 cases taken cesarean operations in The Fourth Affiliated Hospital of Guangxi Medical University（ Worker’s Hospital of Liuzhou City） from October 2011 to September 2013 were retrospectively analyzed,300 cases were divided into two groups according to the different methods of the epidural anesthesia during the operation,180 cases in observation group were treated by lidocaine combined with fentanyl,120 cases in control group were treated by lidocaine. The anesthesia effect were observed,including the effective time of block,the anesthetic dosage,pain disappearing time,adverse reaction,and the Apgar scores of neonates. Results It was found that in observation group the pain disappeared more quickly,the effective time of block was longer,and anesthetic dosage was less than control group（ P 〈 0. 05）. But the rate of adverse reaction and the 1 minute and 5 minutes Apgar score of neonatal had no significant difference between the two groups（ P 〉 0. 05）. Conclusion Lidocaine combined with fentanyl in the epidural anesthesia for the caesarean operation is safe and effective.