瑞芬太尼在血小板减少剖宫产手术中的应用

发布时间：2018-03-14 03:32

本文选题：分娩　切入点：血小板减少　出处：《重庆医学》2015年16期 　论文类型：期刊论文

【摘要】：目的探讨瑞芬太尼在产科全身麻醉应用中的安全性。方法选择妊娠合并血小板减少(Plt7.0×109/L),术前无胎儿宫内窘迫综合征须行剖宫产手术患者42例,按麻醉方式不同分为两组,A组(局部麻醉+全身麻醉)采用局部麻醉下剖宫取胎后改为全身麻醉12例;B组(全身麻醉)切皮前开始麻醉诱导及气管插管30例。麻醉诱导均采用丙泊酚、维库溴铵、瑞芬太尼,B组胎儿剖出后再加用咪达唑仑2mg,全身麻醉维持均用泵注丙泊酚、瑞芬太尼维持麻醉。观察从切皮至胎儿娩出时间和娩出后即刻、1、5、10min时的Apgar评分和产妇的血流动力学变化。结果两组胎儿娩出时间均在10min内,娩出后Apgar评分均高于8分,B组较A组血流动力学更平稳,产妇痛苦少。结论瑞芬太尼全身麻醉对新生儿Apgar评分无明显影响,用于剖宫产安全可行。
[Abstract]:Objective to investigate the safety of remifentanil in general anesthesia in obstetrics. Methods 42 cases of pregnancy complicated with thrombocytopenia (PLT 7.0 脳 10 9 / L) and 42 patients without intrauterine distress syndrome undergoing cesarean section were selected. According to the different anesthetic methods, two groups were divided into two groups: group A (local anesthesia, general anesthesia) and group B (30 cases) were anesthetized before skin incision and endotracheal intubation. All of them were induced by propofol. Vecuronium bromide, remifentanil group B fetus were dissected and then treated with midazolam 2 mg. General anesthesia was maintained by pump injection of propofol. Remifentanil was used to maintain anaesthesia. The Apgar score and hemodynamic changes of parturient were observed from cut skin to fetal delivery and immediately after delivery. Results the delivery time of both groups was within 10 minutes. The Apgar score of group B was higher than that of group A after delivery, and the hemodynamics of group B was more stable than that of group A. ConclusionGeneral anesthesia of remifentanil has no significant effect on Apgar score of newborn, and it is safe and feasible to use it in cesarean section.
【作者单位】：重庆市荣昌县人民医院麻醉科;第三军医大学新桥医院麻醉科;
【分类号】：R614

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