鞘内注射硫酸镁对重度子痫前期患者腰麻剖宫产的影响

发布时间：2019-04-11 07:53

【摘要】：目的研究鞘内注射硫酸镁对重度子痫前期患者腰麻剖宫产麻醉效果的影响。方法 60例重度子痫前期、妊娠36周以上的初产妇,随机分为两组,每组30例。硫酸镁组鞘内注射0.5%布比卡因2 m L+舒芬太尼2.5μg+硫酸镁50 mg,对照组给予0.5%布比卡因2 m L+舒芬太尼2.5μg。若术中患者诉疼痛,静脉给予芬太尼1μg·kg-1,术后给予芬太尼自控镇痛。记录感觉和运动阻滞的起效时间、维持时间,麻醉持续时间,术后芬太尼用量,并观察不良反应及婴儿情况。结果硫酸镁组麻醉维持时间(233.4±17.2)min,运动阻滞持续时间(204.8±20.1)min,均长于对照组[(192.4±12.4)、(173.6±17.5)min,P0.05]。术后4 h硫酸镁组VAS评分低于对照组(P0.05),术后24 h硫酸镁组芬太尼用量(157.3±45.5)μg,低于对照组[(243.5±48.7)μg,P0.05]。两组低血压、心动过缓、恶心和呕吐、瘙痒发生率均无显著差异(P0.05)。胎儿娩出后1 min和5min的Apgar评分都在7分以上。结论重度子痫前期患者剖宫产,鞘内注射硫酸镁可以延长麻醉作用时间并减少术后镇痛药的用量,且不增加胎儿和母体的不良反应。
[Abstract]:Objective to study the effect of intrathecal injection of magnesium sulfate on cesarean section anesthesia in patients with severe preeclampsia. Methods 60 pregnant women with severe preeclampsia over 36 weeks of pregnancy were randomly divided into two groups with 30 cases in each group. 0.5% bupivacaine 2 mL sufentanil 2.5 渭 g mg 50 mg, control group was given 0.5% bupivacaine 2 mL sufentanil 2.5 mg 路kg-1 intrathecally. If the patient complained of pain during the operation, fentanyl was given patient-controlled analgesia after intravenous fentanyl 1 渭 g kg-1,. The onset time of sensory and motor block, duration of anesthesia, dosage of fentanyl after operation were recorded, and adverse reactions and infants were observed. Results the duration of motor block in magnesium sulfate group was significantly longer than that in control group [(233.4 卤17.2) min, vs (204.8 卤20.1) min,] [(192.4 卤12.4), () 173.6 卤17.5 min,P0.05]. The VAS score in magnesium sulfate group was lower than that in control group at 4 h after operation (P0.05), and the fentanyl dosage in magnesium sulfate group was (157.3 卤45.5) 渭 g at 24 h after operation, which was lower than that in control group [(243.5 卤48.7) 渭 g, P0.05]. There was no significant difference in the incidence of hypotension, bradycardia, nausea, vomiting and pruritus between the two groups (P0.05). The Apgar scores of 1 min and 5min were above 7 after delivery. Conclusion Intrathecal injection of magnesium sulfate can prolong the duration of anesthesia and decrease the dosage of postoperative analgesia in severe pre-eclampsia patients without increasing the adverse reactions of fetus and mother.
【作者单位】：浙江大学医学院附属妇产科医院麻醉科;嘉兴市妇幼保健院;
【基金】：浙江省嘉兴市科技局资助项目(2013AY21050-2)
【分类号】：R614

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