腰硬联合麻醉与单用腰麻针在剖宫产中的应用效果对比观察研究

A Comparative Observation Study of the Effect of Combined Anesthesia and Lumbar Anesthesia Needle in Cesarean Section

目的对比腰硬联合麻醉(CSEA)与单用腰麻针腰麻(SA)在剖宫产患者中的应用效果对比观察。方法选择2021年7月至2023年5月剖宫产患者200例为对象,按随机数字法分为两组各100例。CSEA组采用腰硬联合麻醉,SA组采取单用腰麻针麻醉,两组手术结束后评估效果,比较两组麻醉操作时间(从消毒开始到患者平躺于手术床上)、麻醉质量(麻醉起效时间、麻醉达到最高阻滞平面时间)、胎儿娩出阿氏评分(Apgar)、母亲生命体征及麻醉安全性。结果SA组麻醉操作时间短于CSEA组(P<0.05);两组麻醉起效、达到最高阻滞平面时间无统计学意义(P>0.05);两组1min和-5min Apgar评分无统计差异(P>0.05);两组T1、T2及T3时间点伴有不同程度生命体征波动,无意义(P>0.05);麻醉相关并发症(神经根刺激症状、硬膜外置管回血)SA组发生率低于CSEA组(P<0.05);SA组母亲满意度高于CSEA组。结论腰硬联合麻醉与单用腰麻针麻醉用于剖宫产手术中麻醉质量相当,且对胎儿影响较小,但是采用单用腰麻针麻醉操作时间更短,穿刺并发症少,能降低腰痛发生率,但其维持时间短,临床上应权衡利弊,选择合适麻醉方法。

Objective To compare the effect of combined lumbar anesthesia(CSEA)and single lumbar anesthesia(SA)in patients with cesarean section.Methods 200 patients with cesarean section from July 2021 to May 2023 were selected,and the random number method was divided into 100 patients in two groups.CSEA group using waist hard combined anesthesia,SA group take single lumbar anesthesia needle anesthesia,two groups after the operation,compare the two groups of anesthesia operation time(from disinfection to the patient lying flat on the operating bed),anesthesia quality(anesthesia onset time,anesthesia to the highest plane block time),fetal delivery score(Apgar),maternal vital signs and anesthesia safety.Results SA group was shorter than CSEA group(P<0.05);anesthesia onset and time to the highest block plane were not statistically significant(P>0.05);1min and-5min Apgar scores(P>0.05),T1,T2 and T3 time with vital signs fluctuation(P>0.05);anesthesia-related complications(nerve root stimulation symptoms,epidural tube back blood)SA group was less than ESCA group(P<0.05);maternal satisfaction in SA group was higher than CSEA group.Conclusion The quality of anesthesia is similar to lumbar anesthesia for cesarean section,and the impact on the fetus is small.However,the anesthesia has a shorter operation time and less puncture complications,which can reduce the incidence of low back pain,but its maintenance time is short,which should weigh the advantages and disadvantages and choose the appropriate anesthesia method.