瑞芬太尼复合丙泊酚用于剖宫产全身麻醉对母婴的影响

Impact exploration of remifentanil combined with propofol for general anesthesia on mothers and newborns in cesarean delivery

目的:探讨瑞芬太尼复合丙泊酚用于剖宫产全身麻醉对母亲和新生儿的影响。方法:选择ASAⅠ~Ⅱ级、孕37~41周择期剖宫产产妇50例,随机分为两组。R组(瑞芬太尼组)采用丙泊酚1~1.5 mg/kg、瑞芬太尼1μg/kg、顺苯磺酸阿曲库铵5 mg/kg全身麻醉诱导。K组(氯胺酮组)采用氯胺酮1~2 mg/kg、丙泊酚1~1.5 mg/kg、顺苯磺酸阿曲库铵5 mg/kg全身麻醉诱导。比较两组产妇麻醉诱导前(T0)、气管插管后(T1)、手术结束时(T2)的血压、心率;比较两组新生儿1 min、5 min的Apgar评分及新生儿娩出时脐动脉血气分析。结果:R组产妇血流动力学较K组更为稳定,差异有统计学意义(P<0.05)。R组产妇术后苏醒更迅速、更彻底,差异有统计学意义(P<0.05)。两组新生儿脐动脉血气分析及Apgar评分比较,差异无统计学意义(P>0.05)。结论:瑞芬太尼复合丙泊酚剖宫产全身麻醉诱导平稳,不影响新生儿Apgar评分,产妇苏醒迅速,值得临床推广应用。

Objective:To explore the impact of remifentanil combined with propofol for general anesthesia on mothers and newborns in cesarean delivery.Methods:50 cases of ASA Ⅰ~Ⅱ maternal with 37~41 weeks who accepted cesarean delivery were divided into the two groups randomly.R group(remifentanil group) induced general anesthesia with propofol 1~1.5 mg/kg, remifentanil 1 μg/kg and benzene sulfonic acid atracurium 5 mg/kg.K group(ketamine group) induced general anesthesia with ketamine 1~2 mg/kg,propofol 1~1.5 mg/kg and benzene sulfonic acid atracurium 5 mg/kg.The blood pressure,heart rate of maternal in the two groups before anesthesia induction(T0),endotracheal intubation (T1),at the end of surgery after (T2) were compared.The umbilical arterial blood gas at childbirth and Apgar score of 1 min and 5 min after childbirth in the two groups of neonatal were compared.Results:The hemodynamic parameters of R group was more stable than that of the K group,and the difference was statistically significant(P<0.05).The maternal awaken of R group was faster and more thoroughly,and the difference was statistically significant(P<0.05).The umbilical artery blood gas analysis and Apgar score of the groups of neonatal were compared,and there was no statistically significant difference(P>0.05).Conclusion:Remifentanil combined with propofol in cesarean delivery induces general anesthesia smoothly,which do not affect the Apgar score of neonatal,and the maternal wakes up quickly,worthy of clinical popularization and application.