首页|硬膜外麻醉、腰硬联合麻醉用于剖宫产术中麻醉及术后镇痛效果对比

硬膜外麻醉、腰硬联合麻醉用于剖宫产术中麻醉及术后镇痛效果对比

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目的:对比硬膜外麻醉、腰硬联合麻醉用于剖宫产手术中麻醉及术后镇痛效果.方法:选取2021年3月—2023年3月本院收治拟行剖宫产产妇92例,按照麻醉方式分为对照组45例(硬膜外麻醉)和联合组47例(腰硬联合麻醉).对比两组手术围术期指标、术中麻醉效果、术后2 h(T1)、术后5 h(T2)、术后12 h(T3)、术后1 d(T4)、术后2 d(T5)视觉模拟评分(VAS)、镇静评分(Ramsay)及不良反应.结果:联合组手术时间、麻醉时间、胎儿娩出时间均短于对照组,术中辅助用药产妇比例(42.6%)低于对照组(69.9%),麻醉总有效率(97.9%)高于对照组(86.7%),T1、T2、T3、T4、T5 时 VAS 评分(5.43±1.01 分、4.01±1.12 分、3.81±1.23 分、2.18±0.11 分、1.46±0.12 分)均低于对照组(6.93±1.25 分、5.96±1.91 分、4.96±1.74 分、2.78±0.38 分、1.79±0.65 分),两组术后 Ramsay 评分均上升联合组T1、T2、T3、T4、T5时评分均高于对照组,不良反应发生率(17.0%)低于对照组(42.2%)(均P<0.05).结论:剖宫产手术中应用腰硬联合麻醉在比硬膜外麻醉麻醉效果更佳,可减轻产妇术后疼痛,降低不良反应,具有一定安全性.
Comparative study on the anesthesic effect and postoperative analgesia of the epidural anesthesia and the combined lumbar and epidural anesthesia during caesarean section
Objective:To compare the anesthesic effect and the postoperative analgesia of the epidural anesthesia and the combined lumbar and epidural anesthesia during caesarean section of women.Methods:92 pregnant women who wanted caesarean section were selected and were divided into control group(45 women with epidural anesthesia)and experimental group(47 women with combined epidural anesthesia)according to the anesthesia method during caesare-an section from March 2021 to March 2023.The perioperative indexes values,the intraoperative anesthesia effect,the score of visual analogue scale(VAS)at postoperative 2h(T1),postoperative 5h(T2),postoperative 12h(T3),post-operative 1d(T4)or postoperative 2d(T5),the sedation score(Ramsay)and the adverse reactions rate of the women were compared between the two groups.Results:The operation time,the anesthesia time,and the fetal delivery time of the women in the experimental group were significantly shorter than those of the women in the control group.The proportion of the auxiliary drugs(42.6%)of the women in the experimental group was significantly lower than that(69.9%)of the women in the control group.The total effective rate of anesthesia(97.9%)of the women in the experi-mental group was significantly higher than that(86.7%)of the women in the control group.The VAS scores of the women in the experimental group at T1,T2,T3,T4 and T5(5.43±1.01 points,4.01±1.12 points,3.81±1.23 points,2.18±0.11 points and 1.46±0.12 points)were significantly lower than those(6.93±1.25 points,5.96±1.91 points,4.96±1.74 points,2.78±0.38 points and 1.79±0.6 5 points)of the women in the control group.The postop-erative Ramsay score of the women in the two groups had increased significantly,and which of the women in the experimental group at T1,T2,T3,T4 or T5 was significantly higher than that of the women in the control group.The incidence of adverse reactions(17.0%)of the women in the experimental group was significantly lower than that(42.2%)of the women in the control group(all P<0.05).Conclusion:The anesthesic effect of the combined lumbar and epidural anesthesia during caesarean section of the women is better than that of the epidural anesthesia,which can relieve the pain and decrease the adverse reaction of the women after caesarean section,and with certain safety.

Caesarean sectionEpidural anesthesiaCombined lumbar and epidural anesthesiaAnesthetic effectPostoperative analgesiaAdverse reaction

张禾、涂英兵、袁娟、张珏、王德勇

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江苏省苏州市中西医结合医院(215101)

剖宫产手术 硬膜外麻醉 腰硬联合麻醉 麻醉效果 术后镇痛 不良反应

2022年度省老年健康科研项目

LKM2022031

2024

中国计划生育学杂志
国家人口计生委科学技术研究所

中国计划生育学杂志

CSTPCD
影响因子:1.759
ISSN:1004-8189
年,卷(期):2024.32(9)