静脉预注甲氧明对剖宫产腰-硬联合麻醉低血压的防治效果

Effect of intravenous pre-injection of methoxamine in prevention of hypotension after combined spinal-epidural anesthesia in caesarean section

目的研究分析静脉预注甲氧明对剖宫产腰-硬联合麻醉低血压的防治效果。方法 80例行剖宫产产妇,随机分成对照组与观察组,每组40例。对照组采用剖宫产腰-硬联合麻醉时无预防措施;观察组在应用剖宫产腰-硬联合麻醉前给予静脉预注甲氧明。统计比较两组患者麻醉前(T1)、麻醉后5 min(T2)、麻醉后10 min(T3)以及手术结束(T4)时的血压、心率、新生儿血气指标水平以及不良反应情况。结果 T1时两组收缩压(SBP)、舒张压(DBP)及心率(HR)水平比较差异均无统计学意义(P>0.05);T2、T3、T4时观察组SBP、DBP与HR水平均显著高于对照组,差异均具有统计学意义(P<0.05)。观察组新生儿动脉血二氧化碳分压(Pa CO2)、动脉血氧分压(Pa O2)水平显著优于对照组,差异均具有统计学意义(P<0.05)。观察组麻醉术后低血压、恶心、心悸、心动过缓发生率2.50%、2.50%、0、2.50%均低于对照组15.00%、17.50%、10.00%、15.00%,差异均具有统计学意义(P<0.05)。结论静脉预注甲氧明在剖宫产腰-硬联合麻醉中能够有效预防低血压的发生,改善孕妇分娩结局,防治效果更佳,值得应用推广。

Objective To study and analyze the effect of intravenous pre-injection of methoxamine in prevention of hypotension after combined spinal-epidural anesthesia in caesarean section＇. Methods A total of 80 pregnant women with caesarean section were randomly divided into control group and observation group, with 40 cases in each group. The control group received no preventive measures in combined spinal-epidural anesthesia, and the observation group received intravenous pre-injection of methoxamine in combined spinalepidural anesthesia. Statistics and comparison were made on blood pressure, heart rate, neonatal blood gas index level and adverse reaction situation before anesthesia （T1）, 5 min after anesthesia （T2）, 10 min after anesthesia （T3） and at the end of the surgery （T4） in two groups. Results Both groups had no statistically significant difference in systolic blood pressure （SBP）, diastolic blood pressure （DBP）and heart rate （HR） level at T1 （P〉0.05）. The observation group had significantly higher SBP, DBP and HR level at T2, T3 and T4 than the control group, and the difference had statistical significance （P〈0.05）. The observation group had significantly better neonatal arterial partial pressure of carbon dioxide （PaCO2） and arterial partial pressure of oxygen （PaO2） level than the control group, and their difference had statistical significance （P〈0.05）. The observation group had lower incidence of postoperative hypotension, nausea, palpitations and bradycardia as 2.50%, 2.50%, 0 and 2.50% than 15.00%, 17.50%, 10.00% and 15.00% in the control group, and their difference had statistical significance （P〈0.05）. Conclusion Intravenous pre-injection of methoxamine has better preventive effect, which can effectively prevent occurrence of hypotension after combined spinal-epidural anesthesia in caesarean section and improve delivery outcome of pregnant women. So it is worthy of application and promotion.