利多卡因联合芬太尼在剖宫产手术硬膜外麻醉中的效果观察

Effect of Lidocaine Combined With Fentanyl on Epidural Anesthesia During Cesarean Section

目的探讨剖宫产手术中应用利卡多因联合芬太尼联合硬膜外麻醉的临床效果。方法选取2016年5月至2017年5月接受剖宫产的产妇共70例,按照数字抽签法分为对照组和观察组各35例。两组均硬膜外麻醉,对照组单独给予利多卡因麻醉,观察组给予利多卡因联合芬太尼麻醉。观察两组患者阻滞起效时间、麻醉总时间、利多卡因使用剂量、苏醒时间、术中疼痛情况、麻醉效果、下肢运动阻滞程度、新生儿1 min后的Apgar评分、疼痛消失时间和不良反应。结果观察组阻滞起效时间、利多卡因使用总剂量、VAS评分、MBS评分均显著低于对照组(P<0.05);观察组无痛时间显著高于对照组(P<0.05);两组新生儿Apgar评分无明显差异(P>0.05);观察组麻醉有效率显著高于对照组(P<0.05);两组不良反应发生率无明显差异(P>0.05)。结论在剖宫产术中给予芬太尼联合利多卡因硬膜外麻醉,能提高麻醉效果,延长无痛时间,并且降低药物使用剂量,达到理想的麻醉效果,值得临床大力推广。

Objective To explore the clinical application effect of fentanyl combined killer lidocaine epidural anesthesia in cesarean section.Methods From May 2016 to May 2017 underwent cesarean section in 70 cases,according to the number of randomly divided into control group and observation group with 35 cases in each group.The two groups were epidural anesthesia,while the control group was only given lidocaine anesthesia,the observation group was given lidocaine combined with fentanyl anesthesia.Two groups were observed in patients with block onset time,anesthesia time,dosage of lidocaine,recovery time,anesthesia pain,surgery,lower extremity motor blockage degree after neonatal 1min Apgar.And the pain disappeared time and adverse reactions.Results The observation group used lidocaine block onset time,total dose,VAS scores,MBS scores were significantly lower than the control group,P〈0.05;painless time of observation group was significantly higher than the control group,P〈0.05;two groups of neonatal Apgar score no significant difference,P〉0.05;observation groups of patients with anesthesia efficiency was significantly higher than the control group,P〈0.05;incidence of adverse reactions in the two groups was no significant difference.Conclusion In cesarean section treated with fentanyl combined with lidocaine epidural anesthesia can improve the anesthetic effect and prolong the time of pain in 2000,the dosage of drugs was reduced to achieve the ideal anesthetic effect,which is worth popularizing in clinic.