丙泊酚复合雷米芬太尼全身麻醉对剖宫产术中新生儿氧摄取率的影响

发布时间：2018-01-18 14:08

本文关键词：丙泊酚复合雷米芬太尼全身麻醉对剖宫产术中新生儿氧摄取率的影响　出处：《江苏医药》2016年14期 　论文类型：期刊论文

【摘要】：目的比较不同麻醉方法用于剖宫产手术中对新生儿氧摄取率(ERO_2)的影响。方法选择40例行子宫下段剖宫产手术的足月产妇,有椎管内麻醉禁忌证者纳入丙泊酚复合雷米芬太尼全身麻醉组(GA组,20例),无椎管内麻醉禁忌证者纳入硬膜外麻醉组(EA组,20例)。比较两组麻醉开始至胎儿娩出时间(I-D)、子宫切开至胎儿娩出时间(U-D)、新生儿娩出后的脐动静脉血气分析值、ERO_2、Apgar评分和新生儿神经行为学(NBNA)评分。结果 EA组I-D长于GA组(P0.05),两组U-D、新生儿脐动静脉血pH值、PO_2、PCO_2、SpO_2、Hb含量及ERO_2均无统计学差异(P0.05)。GA组新生儿1-min Apgar评分低于EA组(P0.05),两组5-min Apgar评分无统计学差异(P0.05)。所有新生儿24h的NBNA评分大于35分。结论丙泊酚复合雷米芬太尼全身麻醉用于剖宫产手术对新生儿的ERO_2影响较小,但应预防新生儿一过性呼吸抑制。
[Abstract]:Objective to compare the effects of different anesthetic methods on neonatal oxygen uptake rate (ERO _ 2) in cesarean section. Patients with contraindication of intraspinal anesthesia were treated with propofol combined with remifentanil in GA group (n = 20) and those without contraindication of intraspinal anesthesia (n = 20) were included in epidural anesthesia group (group EA). 20 cases were divided into two groups. The time of anaesthesia to fetal delivery was compared. The time of uterine incision to fetal delivery was U-D1. The umbilical artery and vein blood gas analysis value of newborn was compared. Results the I-D of EA group was longer than that of GA group (P 0.05). There was no significant difference in the content of Hb and ERO_2 in PCO2SpO2Hb. The Apgar score of newborn in GA group was lower than that in EA group (P 0.05). There was no significant difference in 5-min Apgar score between the two groups (P0.05). Conclusion the effect of propofol combined with remifentanil general anesthesia on neonatal ERO_2 is small. However, temporary respiratory suppression should be prevented in newborns.
【作者单位】：南京医科大学第一附属医院(江苏省人民医院)麻醉科;
【分类号】：R614.2
【正文快照】： 剖宫产手术有多种麻醉方式,主要以椎管内麻醉为主。对于有椎管内麻醉禁忌证或阻滞不全及紧急剖宫产者(如胎盘早剥、脐带脱垂、先兆子宫破裂等),常采用全身麻醉。本研究拟比较连续硬膜外麻醉和全凭静脉麻醉对新生儿氧摄取率(ERO2)的影响,进一步探讨常规剂量的全身麻醉药物是否

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