不同侧卧方向穿刺对产妇腰麻后仰卧低血压综合征的影响

Effects of Punctures in Different Lateral Directions on the Supine Hypotension Syndrome in Pregnant Women Undergoing Spinal Anesthesia

目的:观察不同侧卧方向穿刺体位下腰麻后对产妇仰卧位低血压综合征发生情况的影响。方法:择期剖宫产术孕妇140例,随机均分为2组,术前分别采用左侧卧位(L组)、右侧卧位(R组)于L2-3间隙行腰麻穿刺并注入0.5%等比重布比卡因2mL。比较2组患者麻醉效果、生命体征变化、仰卧位低血压综合征的发生情况及其处理的差异。结果:两组患者麻醉效果差异无统计学意义(P>0.05),L组麻醉后麻黄碱使用剂量低于R组(P<0.05);L组患者麻醉后仰卧位低血压综合征发生率显著低于R组(P<0.01)。结论:腰麻下剖宫产产妇采用左侧卧位穿刺可以显著降低麻醉后仰卧位低血压综合征的发生率。

Objective:To investigate the effects of punctures in different lateral directions on the supine hypotension syndrome(SHS)in pregnant women undergoing spinal anesthesia.Methods:140pregnant women ready for caesarean section had randomly assigned into two groups(n=70),the group L and the group R.Before operations anesthesia had been used for both the groups by punctures between the second and third vertebra with 2mL 0.5%isobaric bupivacaine respectively,the left recumbent position adopted in group L and the right recumbent position in group R.The following aspects had been compared:the effects of anesthesia,the vital sign changes,whether they suffered from supine hypotension syndrome and the treatment differences.Results:There was no significant difference between the group R and L in the anesthesia effects(P>0.05).The dosage of ephedrine in the group L was lower than that in the group R(P<0.05);the supine hypotension syndrome incidence in the group L was significantly lower than that in group R(P<0.01).Conclusion:The spinal anesthesia in the left recumbent position can significantly reduce the incidence of supine hypotension syndrome after anesthesia.