李春江



腰硬联合麻醉与硬膜外麻醉在剖宫产术中麻醉效果观察

李春江

【摘要】目的 研究分析腰硬联合麻醉和硬膜外麻醉应用于剖宫产麻醉治疗的效果。方法 根据我院接收的100例剖宫产产妇进行研究分析，将其分成I和II组，I组使用腰硬联合麻醉，II组使用硬膜外麻醉，对两组患者的血压、麻醉平面上界时间、麻醉效果等进行对比分析。结果两组患者的血压均有所降低，血压降低出现时间，I组比II组早，上升到各个麻醉平面上界的时间Ⅰ组短于Ⅱ组，I组麻醉效果比II组优秀，差异有统计学意义。结论 腰硬联合麻醉和硬膜外麻醉能够满足剖宫产患者手术需求，腰硬联合麻醉的见效时间短，不良反应少，在剖宫产急腹症中适合。

【关键词】腰硬联合麻醉；硬膜外麻醉；剖宫产术；麻醉效果

Objective To study the combined spinal epidural anesthesia and epidural anesthesia in cesarean section anesthesia． Methods According to received 100 cases of cesarean section parturients to conduct research and analysis in our hospital，were divided into group I and group II． Group I using combined spinal epidural anesthesia and group II using the epidural anesthesia，two groups of patients with blood pressure，anesthesia plane bound time，anesthetic effect were compared and analyzed． Results Two groups of patients with blood pressure decreased，lower blood pressure and time，group I was earlier than group II，rise to various anesthesia of the upper level of time，group I was shorter than that of group II and group I anesthetic effect was better than that of group II． The results showed statistically difference． Conclusion Combined spinal epidural anesthesia and epidural anesthesia for cesarean section patients received surgical needs，lumbar epidural anesthesia，the effective time is shorter，less adverse reaction，in cesarean section patients with acute abdomen using more suitable．

【Key words】 Combined spinal epidural anesthesia，Epidural anesthesia，Cesarean section，Anesthesia

剖宫产手术麻醉治疗需要保证母婴安全，硬膜外麻醉见效慢，阻滞不完全，肌松效果不佳，现在腰硬联合麻醉见效快，在剖宫产手术中使用较多［1-2］。此次我院对腰硬联合麻醉和硬膜外麻醉的临床效果进行对比分析，现进行以下报道。

1 资料与方法

1.1 一般资料

选取我院100例剖宫产产妇来进行研究分析，年龄最小患者21岁，最大患者36岁，全部患者没有妊娠合并症，辅助检查显示无异常情况。将这些患者分成I、II两组，其一般性资料差异无统计学意义。

1.2 麻醉方法

两组孕妇进入手术室开放静脉通道，常规吸氧，同时监测心率、血压和脉搏血氧饱和度，快速滴注林格氏注射液500 ml。Ⅰ组：侧卧位局麻下行腰硬联合穿刺，L2～L3椎间隙穿刺，硬膜外穿刺成功后置入25号腰穿针（针内针法），见脑脊液溢出后根据身高体重注入0.5%布比卡因2～2.5 ml，取出腰穿针，头向置管3～4 cm。……