剖宫产患者的瑞芬太尼联合丙泊酚全麻效果分析

Analysis of General Anesthesia Effect of Remifentanil Combined with Propofol in Patients with Cesarean Section

目的 探究瑞芬太尼联合丙泊酚应用于剖宫产全麻的效果。方法 随机选取2017年5月—2021年5月该院60例剖宫产患者作为研究对象,采用随机数表法分为观察组(瑞芬太尼联合丙泊酚全麻)与对照组(芬太尼联合丙泊酚全麻),各30例。比较两组麻醉前(T1)、切皮时(T2)、娩出时(T3)及结束时(T4)平均动脉压(MAP)、心率(HR)变化情况,新生儿脐动脉血气指标,新生儿Apgar评分,评估肌肉松弛度。结果 两组患者T1、T4时段MAP、HR差异无统计学意义(P>0.05);观察组T2、T3时段MAP、HR高于对照组,差异有统计学意义(P<0.05);与T1时段比较,观察组MAP、HR变化不大,差异无统计学意义(P>0.05),对照组在T2、T3时段MAP、HR出现降低,与T1差异有统计学意义(P<0.05)。两组新生儿脐动脉pH、PaO_(2)、PaCO_(2)指标及新生儿Apgar评分差异无统计学意义(P>0.05)。观察组肌松良好率占93.3%,高于对照组的70.0%,差异有统计学意义(χ^(2)=5.455,P<0.05)。结论 瑞芬太尼联合丙泊酚全麻应用于剖宫产患者,肌松效果好,有利于维持患者血流动力学稳定,且对新生儿结局无影响,安全可靠。

Objective To explore the effect of remifentanil combined with propofol in general anesthesia for cesarean section.Methods A total of 60 cesarean section patients in the hospital from May 2017 to May 2021 were randomly selected as the research objects,and divided into observation group(remifentanil combined with propofol general anesthesia)and control group(fentanyl combined with propofol general anesthesia)by random number table method,30 cases in each group.The changes of mean arterial pressure(MAP)and heart rate(HR)before anesthesia(T1),skin incision(T2),delivery(T3)and end(T4)were compared between the two groups.The umbilical artery blood gas indexes and neonatal Apgar scores were compared between the two groups,and muscle relaxation was assessed.Results There was no statistically significant difference in MAP and HR during T1 and T4 between the two groups(P>0.05);the MAP and HR of the observation group at T2 and T3 were higher than those of the control group,and the difference was statistically significant(P<0.05).Compared with T1 period,the MAP and HR in the observation group did not change much,and the difference was not statistically significant(P>0.05),while the control group decreased in T2 and T3 periods,and the difference was statistically significant(P<0.05).There was no statistically significant difference in umbilical artery pH,PaO_(2),PaCO_(2) indexes and neonatal Apgar score between the two groups(P>0.05).The good rate of muscle relaxation in the observation group was 93.3%,which was higher than 70.0%in the control group,and the difference was statistically significant(χ^(2)=5.455,P<0.05).Conclusion Remifentanil combined with propofol general anesthesia in patients with cesarean section has good muscle relaxation effect,is conducive to maintaining the hemodynamic stability of patients,and has no effect on neonatal outcomes.It is safe and reliable.