不同椎管内麻醉方法在剖宫产术中的临床效果比较

Clinical Effect Comparison of Different Intrathecal Anesthesia Methods in the Cesarean Section

目的为了深入研究不同椎管内麻醉在剖宫产术中的应用效果。方法随机选取2013年8月—2015年12月在该院接受手术治疗的剖宫产患者150例,随机将其分成A组、B组、C组,每组50例,A组使用单次脊麻(CS)、B组使用连续硬膜外麻醉(EA)、C组使用腰硬联合阻滞麻醉(CSEA),对比3组患者的麻醉效果、麻醉起效时间及各自的优缺点。结果相比较于B组,A组与C组的起效时间快,镇痛效果理想,阻滞完善;相比较A组与B组,C组在麻醉时间上可控性高,可弥补单次脊麻作用时间有限的问题,可通过硬膜外导管追加用药,允许更少的脊麻药量,避免平面过高和血压过低的发生率;3组给药方式对新生儿无影响,P>0.05。结论在剖宫产的手术麻醉中,腰硬联合阻滞麻醉有助于镇静管理,能够更好地发挥镇痛效果,具有起效快、麻醉满意度高、阻滞完善,麻醉时间可控等优点,可以在临床治疗中推广应用范围。

Objective To deeply research the application value of different intrathecal anesthesia methods in the cesarean section. Methods 150 cases of patients with cesarean section treated in our hospital from August 2013 to December 2015 were selected and randomly divided into the group A, group B and group C with 50 cases in each, the group A used single spinal analgesia, the group B used continuous caudal anesthesia, the group C used combined spinal-epidural anesthesia （CSEA）, the anesthesia effects, anesthesia onset time and their advantages and disadvantages of the three groups were compared. Results Compared with the group B, the group A and group C have a quick onset time, ideal anesthesia effect and complete block, compared with that of group A and group B, the anesthesia time of the group C has a high controllability, and it can make up for the question that the exposure time of single spinal analgesia was limited, and the less dosage of spinal analgesia was allowed by the additional medication in epidural catheter to decrease the incidence rate of excessive high level and hypopiesia, the three medication methods had no effect on newborns P〉0.05. Conclusion In operative anesthesia of the cesarean section, the combined spinal-epidural anesthesia contributes to sedation management, and it can play a better analgesic role with the advantages of rapid onset, high satisfactory degree of anesthesia, complete block and controllable anesthesia time, which can be widely promoted in clinical treatment.