BioZ系统监测舒芬太尼鞘内给药无痛分娩对妊娠高血压综合征孕妇血流动力学的影响

Impacts of painless delivery with sufentanil intrathecally monitored by BioZ system on hemodynamics of pregnant women with pregnancy-induced hypertension

目的探讨BioZ系统监测舒芬太尼鞘内给药无痛分娩对妊娠高血压综合征孕妇血流动力学的影响。方法选择2019年1~12月在我院行无痛分娩的40例妊娠高血压综合征患者为研究对象,根据麻醉用药方案不同将其分为舒芬太尼组(S组)和罗哌卡因组(R组),每组各20例,两组均在蛛网膜下腔给药后经硬膜外连接镇痛泵实施自控镇痛,其中,S组在蛛网膜下腔推注舒芬太尼,R组在蛛网膜下腔推注罗哌卡因,比较两组围术期镇痛效果、血流动力学指标变化情况。结果S组患者在麻醉后T3、T4、T5的VAS评分显著低于R组(P<0.05)。R组宫口T7时的HR、SV、CO较宫口T6、T8时显著升高,且MAP、SVR、TFC明显降低(P<0.05),而S组不同时间点的血流动力学指标比较,差异无统计学意义(P>0.05)。S组产后皮肤瘙痒发生率较R组要高(P<0.05)。结论BioZ监测系统能够提供全面系统的血流动力学信息,而且对妊娠高血压综合征孕妇予以舒芬太尼鞘内给药无痛分娩的镇痛起效快,持续时间长,并可维持分娩期机体血流动力学稳定。

Objective To investigate the impacts of painless delivery with sufentanil intrathecally monitored by BioZ system on hemodynamics of pregnant women with pregnancy-induced hypertension(PIH).Methods A total of 40 patients with PIH who underwent painless delivery in our hospital from January to December 2019 were selected as the research objects and they were divided into the sufentanil group(group S,n=20)and the ropivacaine group(group R,n=20)according to different anesthetic medication schemes.Both groups were given patient-controlled analgesia through epidural analgesia pump,in which group S was injected with sufentanil in subarachnoid space and group R was injected ropivacaine in subarachnoid space.The analgesic efficacy and hemodynamic indexes were compared between the two groups during perioperative period.Results The VAS scores of patients in group S after T3,T4 and T5 of anesthesia were significantly lower than those in group R(P<0.05).In group R,HR,SV,CO were significantly increased at T7 uterine contraction than those at T6 and T8,and MAP,SVR and TFC were significantly decreased(P<0.05),while there was no statistically significant difference in hemodynamic indexes in group S at different time points(P>0.05).The incidence of postpartum pruritus in group S was higher than that in group R(P<0.05).Conclusion BioZ monitoring system can provide comprehensive and systematic hemodynamic information.Meanwhile,the intrathecal administration of sufentanil to pregnant women with PIH has quick onset,long duration of analgesia in painless labor and can maintain the stability of hemodynamics during labor period.