小剂量等比重腰硬联合麻醉在60例剖宫产手术中的应用

Application of low dose isobaric combined spinal-epidural anesthesia in 60 cases of cesarean section

目的:探讨小剂量等比重腰硬联合麻醉在剖宫产手术中的应用效果。方法:选择180例在我院行剖宫产的单胎孕妇,随机分为A、B、C三组各60例,A组采用等比重腰麻,B组采用等比重硬膜外麻醉,C组采用小剂量等比重腰硬联合麻醉。观察对比三组产妇的麻醉优良率、改良Bromage评分、麻醉起效时间、恢复时间、不良反应发生比例,以及5 min新生儿Apgar评分情况。结果:三组之中,C组产妇麻醉优良率最高,麻醉起效时间、恢复时间最短,不良反应发生比例最低;三组产妇的改良Bromage评分和新生儿Apgar评分组间无显著性差异(P> 0.05)。结论:小剂量等比重腰硬联合麻醉在剖宫产手术中,应用效果佳,产妇循环指标平稳,对新生儿无明显影响,具有临床应用价值。

Objective: To explore the effect of low dose isobaric combined spinal-epidural anesthesia in cesarean section. Methods: One hundred and eighty single pregnant women undergoing cesarean section in our hospital were randomly divided into group A, B and C with 60 cases each. Group A was given isobaric spinal anesthesia, group B was given isobaric epidural anesthesia, and group C was given low dose isobaric combined spinal-epidural anesthesia. The excellent anesthesia rate, the modified Bromage score, the time for anesthesia onset and the recovery, the incidence of adverse reactions and 5 minute neonatal Apgar score were compared among the three groups. Results: Group C had the highest rate of excellent anesthesia, the shortest time for the anesthesia onset and recovery and the lowest incidence of adverse reactions. There were no significant differences among the three groups in the modified Bromage score and the Apgar score of the newborn ( P >0.05). Conclusion: Application of low-dose isobaric combined spinal-epidural anesthesia in cesarean section has good effect, stable maternal circulation index, no significant impact on neonates, and good clinical value.