蛛网膜下腔阻滞麻醉剖宫产术中应用麻黄碱复合去氧肾上腺素对产妇及新生儿的影响

发布时间：2018-04-12 22:02

本文选题：剖宫产 + 蛛网膜下腔阻滞麻醉　；参考：《广西医学》2016年10期

【摘要】：目的探讨蛛网膜下腔阻滞麻醉(腰麻)剖宫产术中应用麻黄碱复合去氧肾上腺素对产妇血流动力学及新生儿动脉血气分析的影响。方法选择腰麻下剖宫产产妇90例,按随机数字表法分为3组,每组30例。腰麻成功后A组静脉注射麻黄碱6 mg、B组静脉注射去氧肾上腺素60μg、C组静脉注射麻黄碱3 mg复合去氧肾上腺素30μg。记录入手术室时(T0)、腰麻注药后2 min(T1)及5 min(T2)、胎儿娩出时(T3)、手术结束时(T4)3组产妇的收缩压(SBP)、舒张压(DBP)及心率(HR),比较3组产妇不良反应发生情况以及新生儿脐动脉血血气分析、生后5 min Apgar评分。结果 3组的SBP、DBP、HR比较,差异均有统计学意义(P0.05),其中在T2至T4,C组SBP及HR水平介于A组及B组之间;各组的SBP、DBP、HR均有随时间变化的趋势(P0.05),腰麻后(T1)A组及B组产妇SBP及DBP较T0明显下降,而C组较T0增高。C组产妇恶心、呕吐发生率低于A、B组(P0.05)。B、C组新生儿的p H和剩余碱高于A组(P0.05),而C组的剩余碱高于B组(P0.05);C组的Pa CO2和乳酸水平均低于A组(P0.05),且C组的Pa O2高于A组及B组(P0.05);3组的新生儿5 min Apgar评分比较,差异无统计学意义(P0.05)。结论腰麻下剖宫产术中,在稳定产妇血流动力、预防低血压、降低不良反应发生率以及减轻新生儿的酸中毒方面,麻黄碱复合去氧肾上腺素优于单用去氧肾上腺素或麻黄碱。
[Abstract]:Objective to investigate the effects of ephedrine combined with norepinephrine on maternal hemodynamics and arterial blood gas analysis during cesarean section under subarachnoid block anesthesia.Methods 90 cases of cesarean section under spinal anesthesia were randomly divided into 3 groups, 30 cases in each group.After spinal anesthesia, ephedrine was injected intravenously in group A (6 mg) and ephedrine was injected intravenously in group B (60 渭 g / g). Group C was treated with ephedrine (3 mg) and noradrenaline (30 渭 g).The systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HRV) were recorded at the end of operation room, 2 min after injection of spinal anaesthesia (T1) and 5 min after injection of drugs. The blood gas of umbilical artery blood gas of newborns was analyzed.Postnatal 5 min Apgar score.But group C was higher than T0. Group C had nausea,Comparison of 5 min Apgar scores of children,The difference was not statistically significant (P 0.05).Conclusion during cesarean section under spinal anesthesia, ephedrine combined with norepinephrine is superior to noradrenaline or ephedrine in stabilizing the blood flow, preventing hypotension, reducing the incidence of adverse reactions and alleviating the acidosis of newborn.
【作者单位】：中南大学湘雅医学院附属海口医院暨海口市人民医院麻醉科;
【分类号】：R614.4

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