瑞芬太尼辅助腰椎-硬膜外麻醉用于急诊剖宫产手术的临床观察-论文.pdf

《瑞芬太尼辅助腰椎-硬膜外麻醉用于急诊剖宫产手术的临床观察-论文.pdf》由会员上传分享，免费在线阅读，更多相关内容在应用文档-天天文库。

1、·26·中国现代药物应用2014年lO月第8卷第19期ChinJModDragAppl，Oct2014，Vo1．8，No．19瑞芬太尼辅助腰椎一硬膜外麻醉用于急诊剖宫产手术的临床观察秦树国张乐赵明陈文丽刘森【摘要】目的观察瑞芬太尼辅助腰椎一硬膜外麻醉减轻患者疼痛及对新生儿Apgar评分和新生儿娩出时SpO影响。方法剖宫产产妇120例随机分为两组，每组60例，选用k。间隙，B—D型腰椎一硬膜外联合穿刺确认成功后，用25G腰穿针行蛛网膜下腔穿刺，见脑脊液回流后注入腰麻药0．75％的盐酸布比卡因1．2ml，向头侧置

2、入导管3．5em，麻醉平面控制在T】。，A组为对照组，术中不辅助瑞芬太尼。B组为观察组，手术开始时静脉滴注瑞芬太尼1．0pg／(kg·h)。结果手术患者牵拉痛VAS评分B组显著低于A组，差异有统计学意义(。新生儿1min及5minApgar评分及SpO比较，差异无统计学意义(P>0．05)，两组患者术中恶心呕吐等不良反应比较，差异无统计学意义(P>0．05)。结论小剂量的瑞芬太尼辅助腰椎一硬膜外麻醉是可行的，能减轻牵拉疼痛及对新生儿Apgar评分和新生儿娩出时SpO：影响极小，对母婴是安全的。【关键词】瑞芬太

3、尼；腰椎一硬膜外麻醉；剖官产手术Clinicalobservationofremifentanilassistedlumbar-epiduralanesthesiainemergencycaesareanoperationQlNShu-guo,ZHANGLe,ZHAOM堍，eta1．DepartmentofAnesthesia,ArmedPoliceCorpsInnerMongoliaHospital,Hohhot010040,China【Abstract】objectiveToobservetheinflu

4、enceofremifentanilassistedlumbar-epiduralanesthesiaonreducingpainandApgarscoreandSpO2ofnewborns．MethodsAtotalof120casesundergonecaesareansectionwererandomlydividedintotwogroup，andeachgroupcontained60cases．AfterconfirmedSUCCESSofL3clearanceandB-Dlumbar-epidu

5、ralpuncture．25GspinalneedleWasconductedforsubarachnoidpuncture．1．2mlof0．75％anestheticbupivacainehydrochlorideWasinjectedaftercerebrospinalfluidreflow．Insertioncatheterwassetcephaladfor3．5cm．ThelevelofanesthesiaWascontrolledatTl0．GroupAwasthecontrolgroupandr

6、eceivednoassistedremifentanildunngoperation．GroupB，astheobservationgroup，wasinjectedby1．0ttC(kg·h)ofremifentanilatthebeginningoperation．ResultsThedraggingpainVASscoreofgroupBWasobviouslylowerthanthatofgroupA，andthediferencehadstatisticalsignificance<0．05)．T

7、herewerenosignifcantdiferencesofnewbornsin1minand5minApgarscoreandSpO2‘P>O．05)．ThediferenceWasnostatisticallysignifcantbetweentheadversereactions，suchasnauseaandvomiting，ofthetwogroups(P>O．05)．ConclusionLumbar-epiduralanesthesiaassistedbysmalldoseofremifent

8、anilisfeasible，anditcanreducedraggingpainandhaslessinfluenceonApgarscoreandSpO2ofnewborns，whichissafeforthemotherandinfant．【Keywords】Remifentanil；Lumbar-epiduralanesthesia；Caesareanoperation本文探讨小剂量的瑞芬太