瑞芬太尼在全身麻醉剖宫产中的应用价值

Application value of Remifentanil in the cesarean section given with general anesthesia

目的研究瑞芬太尼在全身麻醉剖宫产中的应用价值。方法选择2016年1月~2017年3月在我院剖宫产中进行插管全身麻醉的32例产妇作为研究组,在同一时间段选取我院剖宫产行腰硬联合麻醉32例产妇作为对照组,在剖宫产全麻过程中采取瑞芬太尼诱导及维持。实验结束后,观察、分析两组的新生儿Apgar评分,比较两组患者手术前后的心率、血压变化情况。结果两组患者不同时间点的心率差异无统计学意义(P>0.05),且两组患者T_0时的收缩压、舒张压水平差异无统计学意义(P>0.05),但T_1~T_4时,研究组患者的收缩压、舒张压水平均高于对照组(P<0.05);两组患者的术中出血量差异无统计学意义(P>0.05),且两组的新生儿Apgar评分差异无统计学意义(P>0.05)。结论瑞芬太尼在全身麻醉剖宫产中具有较高使用价值,对新生儿心率及呼吸无明显影响,且可有效抑制插管及手术操作所引起应激反应,减少术中出血量,有利于患者术后康复,值得临床推广应用。

Objective To explore the application value of Remifentanil in the cesarean section given with general anes- thesia.Methods 32 puerpera given the general anesthesia of cannula in our hospital from January 2016 to March 2017 were selected the study group.At the same period,32 puerperae given the combined spinal-epidural anesthesia were se- lected the control group.During the process,Remifentanil was used to make the anesthesia induction and maintenance. After surgery,Apgar score in two groups was observed and analyzed,and the change of heart rate and blood pressure be- tween the two groups were compared.Results At the different time point,the heart rate between the two groups was not significantly different （P〉0.05）,and at T0,the systolic blood pressure and diastolic blood pressure between the two groups was not significantly different （P〉0.05）.From TI to T4,the systolic blood pressure and diastolic blood pressure in the study group was higher than that of the control group respectively （P〈0.05）. During surgery,the bleeding volume between the two groups was not significantly different （P〉0.05）.Apgar score between the two groups was not significantly different （P〉0.05）.Conclusion During the general anesthesia of cesarean section,Remifentanil has a higher use value,and it will not produce an obvious effect in the fetal heart rate and respiration,and can effectively inhibit the stress response caused by the intubation and operation,reduce the intraoperative blood loss,and promote the recovery of patients.h is worthy of clinical promotion and application.