摘要
目的探讨不同剂量布比卡因联合芬太尼腰硬联合麻醉对剖宫产术麻醉效果和新生儿状况的影响。方法选取2016年1月至2016年12月本院接收的90例在腰麻下行剖宫产手术的产妇作为研究对象,按不同剂量麻醉方案将其分为对照组和观察组,每组各45例。对照组产妇采用布比卡因5 mg+芬太尼20μg进行腰麻,观察组采用布比卡因7.5 mg+芬太尼25μg进行腰麻。观察比较两组产妇血液动力学指标、麻醉效果、不良反应、新生儿状况等具体情况。结果 (1)观察组产妇T2、T3、T4时间点平均动脉压高于对照组,T4、T5时间点的心率低于对照组,且观察组平均动脉压、心率的变化较对照组更平稳,差异有统计学意义(P<0.05);(2)观察组产妇达到阻滞T10、T6感觉平面的时间均明显低于对照组,VAS最高值低于对照组,差异有统计学意义(P<0.05);(3)对照组产妇不良反应发生率(17.78%)高于观察组(4.44%),差异有统计学意义(P<0.05)。结论布比卡因7.5 mg联合芬太尼25μg对行剖宫产手术的产妇术中麻醉具有一定的效果,其安全性以及有效性明显高于布比卡因5 mg联合芬太尼20μg的腰麻方案,且对新生儿的Apgar评分无不良影响,值得临床推广应用。
Objective To investigate the effect of different doses of bupivacaine combined with fentanyl combined spinal epidural anesthesia on anesthesia effect and neonatal status in cesarean section.Methods 90 cases of parturients undergoing caesarean section under lumbar anesthesiareceived from January 2016 to December 2016 were selected as the research object.They were divided into the control group and the observation group according to the different doses of anesthesia,45 cases in each group.The control group was received with bupivacaine 5 mg+fentanyl 20μg for lumbar anesthesia,while the observation group was received bupivacaine 7.5 mg+fentanyl 25μg for lumbar anesthesia.The hemodynamic parameters,anesthetic effect,adverse reaction and neonatal condition of the two groups were observed and compared.Results①The average arterial pressure at T2,T3 and T4 time points in the observation group was higher than those in the control group,and the heart rate at T4 and T5 time points was lower than the control group,and the changes of mean arterial pressure and heart rate in the observation group were more stable than those in the control group,with statistical significance(P<0.05).②the time of blocking T10 and T6 sense plane in the observation group to the was significantly lower than those in the control group.The highest value of VAS was lower than that in the control group,and the difference was statistically significant(P<0.05).③the incidence of adverse reactions in the control group(17.78%)was higher than that in the observation group(4.44%),and the difference was statistically significant(P<0.05).Conclusion Bupivacaine 7.5 mg combined with fentanyl 25μg has a certain effect on the anesthesia of cesarean section,and its safety and effectiveness are significantly higher than that of bupivacaine 5 mg combined with fentanyl 20μg in the lumbar anesthesia program,and there is no adverse effect on the neonatal Apgar score,which should be applied in clinical application.
作者
黄琴
黄承云
Huang Qin;Huang Chengyun(Department of Anesthesiology,Yifeng County People's Hospital of Jiangxi Province,Yichun,Jiangxi,336300,China)
出处
《当代医学》
2019年第1期102-104,共3页
Contemporary Medicine
关键词
布比卡因
芬太尼
腰硬联合麻醉
新生儿状况
临床价值
Bupivacaine
Fentanyl
Combined spinal epidural anesthesia
Neonatal condition
Clinical value
