[1]王 赢,李 辉.硬膜外麻醉与腰硬联合麻醉在剖宫产中的麻醉效果及对血流动力学的影响[J].医学信息,2024,37(17):77-80.[doi:10.3969/j.issn.1006-1959.2024.17.014]
 WANG Ying,LI Hui.Anesthetic Effect of Epidural Anesthesia and Combined Spinal Epidural Anesthesia in Cesarean Section and its Influence on Hemodynamics[J].Journal of Medical Information,2024,37(17):77-80.[doi:10.3969/j.issn.1006-1959.2024.17.014]
点击复制

硬膜外麻醉与腰硬联合麻醉在剖宫产中的麻醉效果及对血流动力学的影响()
分享到:

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
37卷
期数:
2024年17期
页码:
77-80
栏目:
论著
出版日期:
2024-09-01

文章信息/Info

Title:
Anesthetic Effect of Epidural Anesthesia and Combined Spinal Epidural Anesthesia in Cesarean Section and its Influence on Hemodynamics
文章编号:
1006-1959(2024)17-0077-04
作者:
王 赢李 辉
万载县人民医院麻醉科,江西 万载 336100
Author(s):
WANG YingLI Hui
Department of Anesthesiology,Wanzai County People’s Hospital,Wanzai 336100,Jiangxi,China
关键词:
硬膜外麻醉腰硬联合麻醉剖宫产麻醉效果血流动力学
Keywords:
Epidural anesthesiaCombined spinal-epidural anesthesiaCesarean sectionAnesthetic effectHemodynamics
分类号:
R614
DOI:
10.3969/j.issn.1006-1959.2024.17.014
文献标志码:
A
摘要:
目的 观察硬膜外麻醉与腰硬联合麻醉在剖宫产中的麻醉效果及对血流动力学的影响。方法 选取2020年1月-2023年2月在我院行剖宫产的62例产妇为研究对象,采用随机数字表法分为对照组(n=31)和观察组(n=31)。对照组采用硬膜外麻醉,观察组采用腰硬联合麻醉,比较两组麻醉效果、麻醉起效时间、痛觉最高平面、不同时间段产妇血流动力学指标(血压、心率)、不同时间段疼痛(VAS)评分以及不良反应发生情况。结果 观察组麻醉优良率为93.55%,高于对照组的80.65%(P<0.05);观察组麻醉起效时间、痛觉最高平面均短于对照组(P<0.05);两组切皮时产妇心率均高于麻醉前,舒张压、收缩压均低于麻醉前,但观察组心率低于对照组,舒张压、收缩压高于对照组(P<0.05);观察组术后6、12、24 h的VAS评分均小于对照组(P<0.05);观察组不良反应发生率为6.45%,低于对照组的19.35%(P<0.05)。结论 与硬膜外麻醉比较,腰硬联合麻醉在剖宫产中的麻醉效果显著,麻醉起效快速,不仅对血流动力学影响小,而且可显著减轻术后不产妇疼痛度,且可降低麻醉不良反应,具有确切的临床应用优势。
Abstract:
Objective To observe the anesthetic effect of epidural anesthesia and combined spinal-epidural anesthesia in cesarean section and its influence on hemodynamics.Methods A total of 62 parturients who underwent cesarean section in our hospital from January 2020 to February 2023 were selected as the research objects. They were divided into control group (n=31) and observation group (n=31) by random number table method. The control group was treated with epidural anesthesia, and the observation group was treated with combined spinal-epidural anesthesia. The anesthetic effect, anesthesia onset time, highest pain level, maternal hemodynamic indexes (blood pressure, heart rate) at different time periods, pain (VAS) scores at different time periods and adverse reactions were compared between the two groups.Results The excellent and good rate of anesthesia in the observation group was 93.55%, which was higher than 80.65% in the control group (P<0.05). The onset time of anesthesia and the highest level of pain in the observation group were shorter than those in the control group (P<0.05). The heart rate of the two groups during skin incision was higher than that before anesthesia, and the diastolic blood pressure and systolic blood pressure were lower than those before anesthesia, but the heart rate of the observation group was lower than that of the control group, and the diastolic blood pressure and systolic blood pressure were higher than those of the control group (P<0.05). The VAS score of the observation group at 6, 12 and 24 h after operation was lower than that of the control group (P<0.05). The incidence of adverse reactions in the observation group was 6.45%, which was lower than 19.35% in the control group (P<0.05).Conclusion Compared with epidural anesthesia, combined spinal-epidural anesthesia has a significant anesthetic effect in cesarean section, and the onset of anesthesia is rapid. Meanwhile, it not only has little effect on hemodynamics, but also can significantly reduce the postoperative pain of non-pregnant women, and can reduce the adverse reactions of anesthesia. It has significant clinical application advantages.

参考文献/References:

[1]郑伟萍,陈理建.喷他佐辛复合罗哌卡因硬膜外麻醉在剖宫产的应用[J].江苏医药,2018,44(10):1172-1173,1176.[2]陈敏,刘兆辉,史思仁,等.腰硬联合麻醉对妊娠期高血压疾病产妇剖宫产母婴结局的影响[J].中国妇幼健康研究,2018,29(3):114-118.[3]蒙亚珍,郭余福,田丹,等.腰硬联合麻醉下先天性盆腔多脏器畸形合并双下肢废用性萎缩剖宫产1例[J].中国实验诊断学,2017,21(8):1446-1447.[4]翟培尧.单纯硬膜外与腰硬联合麻醉在剖宫产术中效果比较[J].中国计划生育学杂志,2018,26(8):687-690.[5]颜伟,黄新华,邱萍.右美托咪定复合罗哌卡因硬膜外麻醉用于二次剖宫产手术效果观察[J].浙江医学,2018,40(1):90-91.[6]何吉庆,裘雅芬,俎德学,等.剖宫产产妇疼痛视觉模拟评分及血浆皮质醇与其焦虑抑郁状态研究[J].中国预防医学杂志,2018,19(11):871-872.[7]周婕姝,罗东.序贯法测定甲氧明持续泵注预防剖宫产术腰硬联合麻醉后低血压的半数有效量[J].重庆医科大学学报,2021,46(2):223-226.[8]郝凤梅,苗华艳.氯普鲁卡因注射液联合吗啡注射液硬膜外麻醉对剖宫产术后镇痛的临床研究[J].中国临床药理学杂志,2017,33(2):112-115.[9]谢秋明,郭会江.腰麻硬膜外麻醉与硬膜外麻醉在剖宫产中的应用效果比较[J].解放军医药杂志,2018,29(1):97-99,107.[10]徐仙飞,朱曼华.腰硬联合麻醉与硬膜外麻醉用于高龄产妇剖宫产术的效果研究[J].中国妇幼保健,2020,35(2):206-208.[11]凌勇,张凌,孙霞,等.连续硬膜外阻滞麻醉在剖宫产后再次妊娠分娩中的应用及对患者血流动力学的影响[J].中国妇幼保健,2019,34(16):3836-3838.[12]牛富国,李衔强,张彦匣,等.氢吗啡酮对腰硬联合麻醉剖宫产术后镇痛效果、炎性因子、应激反应和免疫功能的影响[J].河北医药,2019,41(6):810-813.[13]田舜,黄翠源,蒲乐华,等.腰硬联合麻醉应用于高原剖宫产手术对患者疼痛介质、应激指标、炎性因子水平的影响[J].海南医学院学报,2019,25(17):1347-1351.[14]岳婷,任静,刘淑香,等.不同麻醉方法对高龄非初产妇机体免疫功能的影响分析[J].中国免疫学杂志,2020,36(8):982-986.[15]何永冠,曹晓霞.硬膜外麻醉与腰硬联合麻醉在剖宫产术中的应用效果比较[J].中国急救医学,2018,36(1):225-226.[16]张世强,刘宏飞,马宏.腰硬膜外联合麻醉和持续硬膜外麻醉在高龄剖宫产手术中的应用[J].中南医学科学杂志,2017,45(6):601-604.[17]唐慧,何虹.腰硬联合麻醉与连续硬膜外麻醉对剖宫产产妇术后结局和血流动力学的影响[J].检验医学与临床,2018,15(21):3224-3227,3231.[18]陈萍,陈奎,何常佑,等.不同麻醉方式对剖腹产孕妇的麻醉效果和血流动力学影响分析[J].西南国防医药,2020,30(7):658-661.[19]邓国魁,李云现,谢红,等.罗哌卡因复合舒芬太尼腰硬联合麻醉用于剖宫产术对血流动力学及肌肉松弛程度的影响[J].河北医学,2021,27(6):1049-1053.[20]杨进斌,吴奕涵.剖宫产术腰-硬联合麻醉中头部抬高可提供稳定的血流动力学以及更适宜的阻滞平面[J].中国实验诊断学,2019,23(11):1946-1948.

相似文献/References:

[1]迟福涛.腰硬联合麻醉在无痛分娩中的效果分析[J].医学信息,2018,31(08):105.[doi:10.3969/j.issn.1006-1959.2018.08.034]
 CHI Fu-tao.Analysis of the Effect of Combined Spinal Epidural Anesthesia in Painless Delivery[J].Journal of Medical Information,2018,31(17):105.[doi:10.3969/j.issn.1006-1959.2018.08.034]
[2]邢 均.全身麻醉联合硬膜外麻醉在宫颈癌手术中的应用及效果评价[J].医学信息,2019,32(01):122.[doi:10.3969/j.issn.1006-1959.2019.01.037]
 XING Jun.Application and Evaluation of General Anesthesia Combined with Epidural Anesthesia in[J].Journal of Medical Information,2019,32(17):122.[doi:10.3969/j.issn.1006-1959.2019.01.037]
[3]王 颖,石显江,陈斯乔,等.多巴胺预注射在剖宫产腰硬联合麻醉的临床应用[J].医学信息,2019,32(11):150.[doi:10.3969/j.issn.1006-1959.2019.11.044]
 WANG Ying,SHI Xian-jiang,CHEN Si-qiao,et al.Clinical Application of Dopamine Pre-injection in Cesarean Section Combined with Spinal Anesthesia[J].Journal of Medical Information,2019,32(17):150.[doi:10.3969/j.issn.1006-1959.2019.11.044]
[4]王海霞.腰麻联合硬膜外麻醉对剖宫产术麻醉效果的影响[J].医学信息,2019,32(20):100.[doi:10.3969/j.issn.1006-1959.2019.20.028]
 WANG Hai-xia.Effect of Spinal Anesthesia Combined with Epidural Anesthesia on the Anesthetic Effect of Cesarean Section[J].Journal of Medical Information,2019,32(17):100.[doi:10.3969/j.issn.1006-1959.2019.20.028]
[5]刘 岩,刘 永.剖宫产产妇硬膜外麻醉术后发生尿储留的危险因素分析[J].医学信息,2020,33(11):111.[doi:10.3969/j.issn.1006-1959.2020.11.034]
 LIU Yan,LIU Yong.Analysis of Risk Factors for Urinary Retention After Epidural Anesthesia for Cesarean Section[J].Journal of Medical Information,2020,33(17):111.[doi:10.3969/j.issn.1006-1959.2020.11.034]
[6]杨晓旭.罗哌卡因联合舒芬太尼腰硬联合麻醉用于剖宫产手术的效果[J].医学信息,2021,34(11):164.[doi:10.3969/j.issn.1006-1959.2021.11.046]
 YANG Xiao-xu.Effect of Ropivacaine with Sufentanil Combined Spinal-epidural Anesthesia for Cesarean Section[J].Journal of Medical Information,2021,34(17):164.[doi:10.3969/j.issn.1006-1959.2021.11.046]
[7]李 晶,孔明健,王亚丽,等.产妇围产期内硬膜外麻醉相关发热对新生儿院内感染风险的影响[J].医学信息,2021,34(13):96.[doi:10.3969/j.issn.1006-1959.2021.13.024]
 LI Jing,KONG Ming-jian,WANG Ya-li,et al.Effect of Fever Related to Epidural Anesthesia During the Perinatal Period of Parturient on the Risk of Nosocomial Infection in Newborns[J].Journal of Medical Information,2021,34(17):96.[doi:10.3969/j.issn.1006-1959.2021.13.024]
[8]单会荣,涂莹莹.腰麻下罗哌卡因复合硬膜外不同剂量舒芬太尼用于剖宫产麻醉的临床效果观察[J].医学信息,2021,34(22):106.[doi:10.3969/j.issn.1006-1959.2021.22.032]
 SHAN Hui-rong,TU Ying-ying.Clinical Effect of Ropivacaine Combined with Different Doses of Sufentanil in Epidural Anesthesia for Cesarean Section Under Spinal Anesthesia[J].Journal of Medical Information,2021,34(17):106.[doi:10.3969/j.issn.1006-1959.2021.22.032]
[9]梁 军.硬膜外麻醉对初产妇分娩疼痛程度、产程进展及分娩结局的影响[J].医学信息,2022,35(14):83.[doi:10.3969/j.issn.1006-1959.2022.14.018]
 LIANG Jun.Effect of Epidural Anesthesia on Labor Pain, Labor Progress and Delivery Outcome in Primipara[J].Journal of Medical Information,2022,35(17):83.[doi:10.3969/j.issn.1006-1959.2022.14.018]
[10]卡地尔丁·艾海提,叶建荣.吗啡不同给药时机对硬膜外麻醉下行剖宫产术患者的麻醉效果及术后镇痛效果的影响[J].医学信息,2022,35(16):51.[doi:10.3969/j.issn.1006-1959.2022.16.011]
 KADIERDING·AIHAITI,YE Jian-rong.Effects of Different Administration Time of Morphine on Anesthesia and Postoperative Analgesia in Patients Undergoing Cesarean Section Under Epidural Anesthesia[J].Journal of Medical Information,2022,35(17):51.[doi:10.3969/j.issn.1006-1959.2022.16.011]
[11]帅国象,韩 艳,周 娜,等.腰硬联合麻醉与硬膜外麻醉对无痛分娩产妇 ACTH、Cor、CRP的影响[J].医学信息,2020,33(24):110.[doi:10.3969/j.issn.1006-1959.2020.24.030]
 HUAI Guo-xiang,HAN Yan,ZHOU Na,et al.The Effect of Combined Spinal-epidural Anesthesia and Epidural Anesthesia on ACTH, Cor and CRP of Parturients in Painless Delivery[J].Journal of Medical Information,2020,33(17):110.[doi:10.3969/j.issn.1006-1959.2020.24.030]

更新日期/Last Update: 1900-01-01