左旋布比卡因混合舒芬太尼在子痫前期患者剖宫产手术中的麻醉效果

Anesthetic effect of levobupivacaine combined with sufentanil in cesarean section in patients with preeclampsia

目的 观察子痫前期患者剖宫产手术中左旋布比卡因混合舒芬太尼的麻醉效果。方法 采用回顾性分析方法,以2020年1月至2021年10月安康市中心医院收治的90例子痫前期患者为研究对象。根据剖宫产手术麻醉方式分为对照组(n=45)与研究组(n=45)。对照组行左旋布比卡因麻醉,研究组行左旋布比卡因混合舒芬太尼麻醉。比较两组患者不同时间段(麻醉后5、10、15 min)血流动力学指标(心率、平均动脉压)水平、疼痛评分与感觉阻滞情况(达最高阻滞平面时间、感觉阻滞起效时间)、新生儿Apgar评分、寒战发病率及麻醉效果。结果 两组患者术前血流动力学指标水平差异无统计学意义(P> 0.05)。与术前相比,两组患者麻醉后5、10、15 min平均动脉压明显降低,差异均有统计学意义(P <0.05),而心率差异无统计学意义(P> 0.05);两组患者麻醉后5、10、15 min心率、平均动脉压差异无统计学意义(P> 0.05)。研究组术后1、6、12、24 h疼痛评分明显低于对照组,达最高阻滞平面时间、感觉阻滞起效时间明显短于对照组,差异均有统计学意义(P <0.05)。两组新生儿1、5 min的Apgar评分差异无统计学意义(P>0.05)。观察组的寒战发病率为6.67%,显著低于对照组(24.44%),差异有统计学意义(P <0.05)。研究组麻醉效果优良率为100.00%,明显高于对照组(86.67%),差异有统计学意义(P <0.05)。结论 子痫前期患者剖宫产手术中左旋布比卡因混合舒芬太尼的麻醉效果显著,可维持患者血流动力学稳定,降低其疼痛程度,且感觉阻滞起效迅速,可减少寒战,对新生儿无显著影响。

Objective To observe the anesthesia effect of levobupivacaine mixed with sufentanil during cesarean section in patients with preeclampsia.Methods Ninety cases of pre-epilepsy patients admitted to Ankang Central Hospital from January 2020 to October 2021 were retrospectively selected as the research objects.According to the anesthesia method of the cesarean section,they were divided into a control group( n = 45) and a study group( n = 45).The control group underwent levobupivacaine anesthesia,and the study group underwent levobupivacaine combined with sufentanil anesthesia.The blood flow of the two groups of patients at different time periods( 5 min,10 min,15 min after anesthesia) Kinetic indicators( heart rate,mean arterial pressure) level,pain score and sensory block( time to reach the highest block level,sensory block onset time),neonatal Apgar score,incidence of chills,and anesthesia effect were compared.Results Before operation,there was no significant difference in hemodynamic index levels between the two groups of patients( P > 0.05);compared with before operation,the average arterial pressure of the two groups was significantly reduced at 5 min,10 min,and 15 min after anesthesia,the differences were statistically significant( P < 0.05),while the heart rate differences were not statistically significant( P > 0.05);there was no statistically significant difference in heart rate and mean arterial pressure between the two groups of patients at 5 min,10 min,15 min after anesthesia( P > 0.05).The pain scores of the study group at 1 h,6 h,12 h,and 24 h after surgery were significantly lower than those of the control group,and the time to the highest block level and the onset time of sensory block were significantly shorter than those in the control group.There was no significant difference in Apgar scores between the two groups of newborns at 1 min and 5 min( P > 0.05).The incidence of chills in the observation group was 6.67%,which was significantly lower than that in the control group( 24.44%),and the difference was statistically significant( P < 0.05).The excellent and good rate of anesthesia effect in the study group( 100.00%) was significantly higher than that in the control group( 86.67%),and the difference was statistically significant( P < 0.05).Conclusion The anesthetic effect of levobupivacaine combined with sufentanil in cesarean section of preeclampsia patients is significant,which can maintain hemodynamic stability and reduce the pain degree of the patients,and sensory block has a rapid effect,which can reduce shivering,and has no significant effect on the newborn.