右美托咪定在全麻剖宫产中的应用效果分析

目的探讨右美托咪定在全麻剖宫产中的应用效果。方法：选取本院2013年10月-2014年12月全麻剖宫产患者116例，采用随机数字表法分为两组，58例全麻诱导前10min静脉泵注右美托咪定1ug／kg为观察组，58例全麻诱导前i0min静脉泵注生理盐水0．8ug／（kg·h）为对照组，行快速顺序诱导后，静脉泵注丙泊酚以维持麻醉。比较两组不同时间点（麻醉前T0、泵注20minT1、气管插管T2、切皮T3、分娩T4、拔管T5）血流动力学指标（心率、舒张压、收缩压）、血气指标（血氧饱和度、血氧分压、血二氧化碳分压），分析相关指标及新生儿预后。结果：对照组血流动力学指标（心率、舒张压、收缩压）、血气指标（血二氧化碳分压）T2时明显增加；血气指标（血氧饱和度、血氧分压）T2时显著降低。观察组血流动力学指标（心率、舒张压、收缩压）、血气指标（血二氧化碳分压）T1时显著降低，T2时明显增加；血气指标（血氧饱和度、血氧分压）T1时显著增加，T2时明显降低。观察组血流动力学指标（心率、舒张压、收缩压）、血气指标（血二氧化碳分压）T1、T2、T3、T4、T5时均明显低于对照组；血气指标（血氧饱和度、血氧分压）T1、T2、T3、T4、T5时均明显高于对照组。观察组催产素使用率、子宫收缩发生率、术后恶心呕吐发生率均明显低于对照组，差异均有统计学意义（P〈0．05）。观察组新生儿分娩l、5、10minApgar评分均高于对照组，拔管时间晚于对照组，差异均无统计学意义（P〉0．05）。结论：右美托咪定有助于稳定全麻剖富产患者的血流动力学指标，可减轻机体的氧化应激反应，并改善血气指标，不良事件少且安全性高。

Objective To investigate application effect of dexmedetomidine in general anesthesia of cesarean section. Methods： 116 patients with general anesthesia of cesarean section were selected in hospital from October 2013 to December 2014, who were randomly divided into two groups. 58 patients treated intravenous infusion of dexmedetomidine 1μg/kg before anesthesia induction 10rain as observation group. 58 patients＇treated intravenous infusion of physiological saline 0.8 ug/（kg.h）before anesthesia induction 10rain as control group. After rapid sequence induction, intravenous infusion of propofolto maintain anesthesia. Hemodynamic indexes （HR,SBP,DBP）; blood gas indexes （SaO2,PaO2,PaCO2） at different time points（before anesthesia TO, infusion 20rain T1, tracheal intubation T2, skin incision T3, delivery T4, delivery TS） were compared between two groups. Related indexes in patients and neonatal prognosis were analyzed. Results： Hemodynamic indexes （HR,SBP,DBP）;blood gas indexes （PaCO2） increased at T2, while blood gas indexes （SaO2,PaO2） decreased at T2 in control group. Hemodynamic indexes （HR,SBP,DBP）; blood gas indexes （PaCO2） decreased at T1, increased at T2, while blood gas indexes （SaO2,PaO2） increased at T1, decreased at T2 in observation group. Hemedynamic indexes（HR,SBP,DBP）; blood gas indexes （PaCO2） at T1 ,T2, T3,T4,T5 in observation group were significantly lower than control group. Blood gas indexes （SaO2,PaO2） at T1 ,T2,T3,T4,T5 in observation group were significantly higher than control group. Oxytocin using rate, incidence of uterine contraction, incidence of postoperative nausea and vomiting in observation group were significantly lower than control group. Differences were statistically significant （P〈0.05）.Apgar scores at delivery lmin,5min,10min in observation group were higher than control group. Extubation time in observation group was later than control group. Differences were not statistically significant （P〉0.05）. Conclusion： Dexmedetomidine is helpful to stabilize hemodynamics in general anesthesia for cesarean section patients,which can reduce oxidative stress response,which can improve blood gas indexes,which has less adverse events and high safety.