腰硬联合套管针的内针腰硬联合硬膜外小剂量氢吗啡酮在剖宫产手术中的临床效果观察

Clinical Observation of Lumbar Epidural Combined with Small dose of Hydromorphone in Desarean Section

目的总结腰硬联合套管针的内针腰硬联合硬膜外小剂量氢吗啡酮在剖宫产手术中的临床应用效果。方法选择2021年9月至2022年9月在我院进行剖宫产的160例产妇作为研究对象,参照随机分组法进行分组,即对照组、试验组,两组产妇均采用腰硬联合套管针的内针腰硬联合麻醉,对照组产妇硬膜外使用生理盐水,而试验组则硬膜外使用小剂量氢吗啡酮,对比两组应用效果。结果①麻醉前、后对照组和试验组产妇的SBP、DBP、HR、SpO_(2)指标比较均无统计学意义,P>0.05。②对照组和试验组产妇的麻醉起效时长比较并无差异,P>0.05;试验组产妇的麻醉持续时间及痛感恢复时长均比对照组长,P<0.05。③在术后6 h、12 h、24 h时试验组产妇的疼痛比对照组更低,P<0.05。④对照组产妇总不良反应(10.00%)与试验组(7.50%)比较并无差异,P>0.05。⑤麻醉前对照组及试验组产妇的IL-6、IL-10、TNF-α指标比较无差异,而试验组产妇上述指标水平均较对照组更低,P<0.05。⑥两组新生儿1 min、10 min、30 min时Apgar评分以及脐动脉血pH值、PaO_(2)、Hct指标比较均无差异,P>0.05。结论腰硬联合套管针的内针腰硬联合硬膜外小剂量氢吗啡酮在剖宫产手术中有着较好的应用效果,能有效减轻产妇疼痛,应用前景广阔。

Objective To summarize the clinical effect of combined spinal epidural anesthesia with small dose of epidural hydromorphone in cesarean section.Methods 160 parturients who underwent cesarean section in our hospital from September 2021 to September 2022 were selected as the study objects.They were divided according to the random grouping method,namely,the control group and the experimental group.The two groups of parturients were both anesthetized with internal acupuncture combined with lumbar and epidural trocar.The control group of parturients used normal saline epidural,while the experimental group used small dose hydromorphone.The effects of the two groups were compared.Results(1)The indexes of SBP,DBP,HR and SpO_(2) in the control group and the experimental group before and after anesthesia were insignificant(P>0.05).(2)There was no difference in the onset time of anesthesia between the control group and the experimental group(P>0.05);the duration of anesthesia and the duration of pain recovery in the experimental group were longer than those in the control group(P<0.05).(3)At 6 hours,12 hours and 24 hours after operation,the pain of the experimental group was lower than that of the control group(P<0.05).(4)There was no difference in total maternal adverse reactions(10.00%)in the control group compared with the experimental group(7.50%),P>0.05.(5)IL-6,IL-10,TNF-αin the control group and experimental group before anesthesia the index is meaningless,after anesthesia,the improvement of the above indexes in the experimental group was better than that in the control group(P<0.05).(6)There was no difference in Apgar scores between the two groups at 1 min,10 min and 30 min and umbilical artery blood pH value,PaO_(2) and Hct indexes in the control group and the experimental group were insignificant(P>0.05).Conclusion The combined spinal epidural anesthesia with small dose of hydromorphone has a good application effect in cesarean section,which can effectively reduce the pain of parturients and has a broad application prospect.