小剂量甲氧明对剖宫产麻醉产妇血流动力学和新生儿血气的影响

发布时间：2018-12-16 19:03

【摘要】：目的探讨小剂量甲氧明对剖宫产手术麻醉中产妇血流动力学和新生儿的影响。方法选取2014年1月至2016年6月间在该院行剖宫产术实施腰-硬联合麻醉产妇285例,分3组,A组麻醉完成后即刻静脉注射盐酸甲氧明1mg,B组注射2mg,C组静脉注射生理盐水2mL,记录入室平静后基础值(T0)、麻醉平卧位即刻(T_1)、麻醉平卧后1min(T_2)、麻醉平卧后5min(T_3)、胎儿娩出前1min(T4)、胎儿娩出后5min(T5)各时间点产妇的收缩压(SBP)、心率(HR)变化情况,新生儿脐动脉血pH、血气指标[氧分压(PO_2),二氧化碳分压(PCO_2)]及出生1min Apgar评分,观察产妇术中出现恶心、呕吐等不良反应情况。结果 B组及C组产妇在T_2时刻HR明显升高后又明显降低(P0.05),而A组产妇在T_1时刻开始降低后,在T_2~T4各时间点HR均明显低于B组及C组,且无较大波动(P0.05);3组产妇的SBP自T_2时刻起均较T0时刻明显降低(P0.05),但在T_2~T4各时间点A组产妇的SBP均明显高于B组及C组(P0.05);A、B组新生儿脐动脉血pH、血气指标及出生1min后Apgar评分组间差异均无统计学意义(P0.05),但C组新生儿脐动脉血pH、出生1min后Apgar评分均明显低于A、B组(P0.05);A组产妇的不良反应率为2.11%,明显低于B组(9.47)%及C组(13.68)%,差异有统计学意义(P0.05)。结论小剂量甲氧明能够有效维持剖宫产术腰硬联合麻醉后产妇血流动力学平稳,对新生儿无不良影响。
[Abstract]:Objective to investigate the effect of low dose methoxifen on hemodynamics of parturient and newborn during cesarean section anesthesia. Methods from January 2014 to June 2016, 285 cases of parturient undergoing combined spinal-epidural anesthesia were divided into 3 groups. Group A received intravenous injection of methoxifen hydrochloride 1 mg / g immediately after anesthesia, and group B received 2 mg of methoxifen hydrochloride immediately after anesthesia. In group C, normal saline was injected intravenously for 2 mL. The baseline value (T _ 0), 1min (T _ 2), 1min (T _ 4) and 1min (T _ 4) before delivery of fetus were recorded in group C, respectively, and were recorded immediately after anaesthesia supine position (T _ 1), 1min (T _ 2) after anaesthesia supine and 5min (T _ s _ 3) after anaesthesia. The changes of systolic blood pressure (SBP),) heart rate (HR), blood gas index (PO_2), partial pressure of carbon dioxide (PCO_2) in umbilical artery of newborn and 1min Apgar score of birth were measured at different time points of 5min (T5) after delivery. The adverse reactions such as nausea and vomiting in parturient were observed. Results in group B and group C, HR increased significantly and then decreased (P0.05), but the HR in group A was significantly lower than that in group B and C at each time point after T _ 1 began to decrease. There was no significant fluctuation (P0.05). The SBP of parturient in group A was significantly higher than that in group B and C at each time point of T_2~T4 (P0.05), but the SBP of parturient in group A was significantly higher than that in group B and group C at each time point (P0.05). There was no significant difference in pH, blood gas index of umbilical artery blood and Apgar score after birth in group A (P0.05), but Apgar score of pH, in group C was significantly lower than that in group B (P0.05). The adverse reaction rate of parturient in group A was 2.11 significantly lower than that in group B (9.47)% and group C (13.68)% (P0.05). Conclusion low dose methoxifen can effectively maintain hemodynamics of parturient after combined spinal-epidural anesthesia in cesarean section, and has no adverse effect on newborn.
【作者单位】：重庆市奉节县人民医院麻醉科;
【分类号】：R614

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