丙泊酚复合瑞芬太尼在高龄妊娠剖宫产术中的临床应用研究

Clinical application of propofol combined with remifentanil in cesarean section of elderly pregnancy

目的探讨丙泊酚复合瑞芬太尼在高龄妊娠剖宫产术中的应用效果。方法选取2016年9月至2019年2月本院收治的100例接受剖宫术的高龄妊娠产妇,随机分为对照组和观察组,各50例。对照组产妇给予丙泊酚靶控输注联合阿曲库胺静脉推注进行麻醉,观察组采取丙泊酚复合瑞芬太尼靶控输注进行麻醉,观察两组产妇不同时段平均动脉压(MAP)、心率(HR)及新生儿Apgar评分。结果观察组诱导后3 min、胎儿娩出时、胎儿娩出后5 min HR明显比对照组更高,差异具有统计学意义(P<0.05);观察组术前、诱导时、诱导后3 min、胎儿娩出时、胎儿娩出后5 min MAP均高于对照组,差异具有统计学意义(P<0.05);两组新生儿娩出后1 min、5 min、10 min新生儿Apgar评分比较差异无统计学意义。结论高龄妊娠剖宫产术中采取丙泊酚复合瑞芬太尼靶控输注可减少产妇麻醉影响,且不会对新生儿造成伤害。

Objective To investigate the effect of propofol combined with remifentanil in cesarean section of elderly pregnancy.Methods 100 elderly pregnant women who underwent cesarean section in our hospital from September 2016 to February 2019 were selected and divided into control group and observation group according to random grouping method,with 50 cases in each group.The control group was given propofol targetcontrolled infusion combined with atracurium intravenous injection for anesthesia,while the observation group was given propofol combined with remifentanil target-controlled infusion for anesthesia.Mean arterial pressure(MAP),heart rate(HR)and neonatal Apgar score were measured in two groups at different time points were compared.Results The observation group was significantly higher than the control group at 3 minutes after HR induction,fetal delivery and 5 minutes after fetal delivery of MAP(P<0.05).Compared with the control group,the observation group was significantly higher at preoperative,induction,3 minutes after induction,fetal delivery and 5 minutes after fetal delivery(P<0.05),and the difference was statistically significant(P<0.05).There was no significant difference in Apgar score among in 1 minute,5 minutes and 10 minutes.Conclusion Target controlled infusion of propofol combined with remifentanil during cesarean section in elderly pregnancy can reduce the influence of maternal anesthesia and does not harm newborns.