摘要
目的分析和研究三种椎管内不同麻醉方式:硬脊膜外隙阻滞(EA)、蛛网膜下隙阻滞麻醉(SA)与经蛛网膜下隙与硬脊膜外隙联合阻滞(CSEA)对剖宫产产妇血流动力学的影响。方法选取我院在2016年4月至2017年5月收治的60例剖宫产产妇为研究对象,并使用随机分组方式将60例剖宫产妇平均分为三组,分别是EA组(n=20)、SA组(n=20)、CSEA组(n=20),其中EA组实施腰1-腰2间隙穿刺,首次使用1.73%的碳酸利多卡因12-15mL;SA组与CSEA组实施腰1-腰2或者腰3-腰4间隙穿刺,其中SA组0.75%布比卡因1.2mL+10%葡萄糖注射液1mL,CSEA组0.5%布比卡因1.4mL+10%葡萄糖注射液0.8mL^([1])。结果在麻药的起效时间比较上,三组剖宫产产妇之间的数据统计具有统计学差异(P<0.05),其中EA组的麻醉起效时间明显高于其他两组,SA组的麻醉诱导时间明显低于其他两组;SA、CSEA组的最低血压和心率较基础值明显偏低,EA组的最低血压和心率明显高于SA组,EA组的低血压和心跳过缓发生率明显低于其他两组。结论在剖宫产产妇椎管内麻醉方式的选择中,CSEA和EA麻醉方式较SA麻醉方式来说具有更大临床应用价值。
Objective To analysis and study of three different anesthesia methods in spinal canal [epidural block(EA), subarachnoid block anesthesia(SA) and subarachnoid space combined with epidural block(CSEA)] on cesarean section hemodynamics. Methods 60 cases of cesarean section in our hospital from April 2016 to May 2017 were selected as study subjects and 60 cases of cesarean section were divided into three groups by randomization: EA group(n=20), SA group(n=20), and CSEA group(n=20). The EA group received lumbar 1-the lumbar 1-or 2-lumbar 3-and lumbar 4-punctured puncture were performed, in which 1.2 mL of bupivacaine 0.75% and 1 mL of 10% glucose injection in SA group and 1.4 mL + 10% glucose injection of 0.5% bupivacaine in CSEA group Liquid 0.8 mL. Results In the comparison of the onset time of anesthetic, there was statistical difference among the three groups(P〈0.05), the onset time of anesthesia in EA group was significantly higher than the other two groups, and the anesthesia induction time in SA group was significantly lower than the other two groups. The lowest blood pressure and heart rate in SA and CSEA groups were significantly lower than those in the baseline. The lowest blood pressure and heart rate in EA group were significantly higher than those in SA group. The incidence of hypotension and bradycardia in EA group was significantly lower than the other two groups. Conclusion In the choice of intracavitary anesthesia in cesarean section, CSEA and EA anesthesia have more clinical value than SA anesthesia.
作者
杜立娟
蔡艳玲
张玉霞
DU Li-juan;CA;ZHANG Yu-xia(People "s Hospital of Langfang, Lang)Cang, Hebei, 06500)
出处
《智慧健康》
2018年第4期171-172,共2页
Smart Healthcare
关键词
椎管内麻醉方式
血流动力学
剖宫产
Intraspinal anesthesia
Hemodynamics
Cesarean delivery