国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2011年
16期
2021-2023
,共3页
吴政元%黄小娟%卢先卿%张建华
吳政元%黃小娟%盧先卿%張建華
오정원%황소연%로선경%장건화
七氟醚%瑞芬太尼%剖宫产
七氟醚%瑞芬太尼%剖宮產
칠불미%서분태니%부궁산
Sevoflurane%Remifentanil%Cesarean section
目的 探讨七氟醚复合瑞芬太尼在剖宫产手术中的麻醉效果,并与异氟醚复合芬太尼比较.方法 将需剖宫产手术的ASA Ⅰ～Ⅱ级的足月产妇40例(23～32岁)随机分为七氟醚复合瑞芬太尼组(Ⅰ组)和异氟醚复合芬太尼组(Ⅱ组)各20例.诱导:Ⅰ组面罩吸入3.5%七氟醚、2～4 L/min流量的氧气、静脉输入瑞芬太尼1μg/kg、丙泊酚1 mg/kg、顺苯阿曲库铵0.1 mg/kg;Ⅱ组静脉注芬太尼0.02 mg/kg丙泊酚2 mg/kg、顺苯阿曲库铵0.1 mg/kg.维持:Ⅰ组吸入1.5%～3.5%七氟醚,胎儿娩出后输注瑞芬太尼0.15μg/(kg·min);Ⅱ组吸入1%～2.5%异氟醚,胎儿娩出后静脉注芬太尼0.02 mg/kg.取新生儿脐动脉(UA)血样1 ml行血气分析.分别记录两组麻醉期间血流动力学的参数、血氧饱和度(SpO2)的变化、麻醉复苏的时间、术中知晓情况以及新生儿Apgar评分、脐动脉血气分析.结果 Ⅰ组诱导后和手术时心率、血压基本保持平稳(P＞0.05).Ⅱ组在诱导后心率和血压下降较Ⅰ组明显(P＜0.05),术后产妇拔管时间[(10.3±3.2)min]和睁眼时间[(15.4±2.3)min]Ⅰ组明显早于Ⅱ组[(18.5±6.3)min,(25.6±3.5)min],差异有显著性(P＜0.05).两组新生儿1、5、10 min Apgar评分均大于7分,脐动脉血气分析差异无显著性(P＞0.05);两组均未见新生儿呼吸抑制及产妇术中知晓发生.结论 吸入七氟醚联合瑞芬太尼在剖宫产手术中的麻醉平稳、效果确切、苏醒快、新生儿无呼吸抑制.
目的 探討七氟醚複閤瑞芬太尼在剖宮產手術中的痳醉效果,併與異氟醚複閤芬太尼比較.方法 將需剖宮產手術的ASA Ⅰ～Ⅱ級的足月產婦40例(23～32歲)隨機分為七氟醚複閤瑞芬太尼組(Ⅰ組)和異氟醚複閤芬太尼組(Ⅱ組)各20例.誘導:Ⅰ組麵罩吸入3.5%七氟醚、2～4 L/min流量的氧氣、靜脈輸入瑞芬太尼1μg/kg、丙泊酚1 mg/kg、順苯阿麯庫銨0.1 mg/kg;Ⅱ組靜脈註芬太尼0.02 mg/kg丙泊酚2 mg/kg、順苯阿麯庫銨0.1 mg/kg.維持:Ⅰ組吸入1.5%～3.5%七氟醚,胎兒娩齣後輸註瑞芬太尼0.15μg/(kg·min);Ⅱ組吸入1%～2.5%異氟醚,胎兒娩齣後靜脈註芬太尼0.02 mg/kg.取新生兒臍動脈(UA)血樣1 ml行血氣分析.分彆記錄兩組痳醉期間血流動力學的參數、血氧飽和度(SpO2)的變化、痳醉複囌的時間、術中知曉情況以及新生兒Apgar評分、臍動脈血氣分析.結果 Ⅰ組誘導後和手術時心率、血壓基本保持平穩(P＞0.05).Ⅱ組在誘導後心率和血壓下降較Ⅰ組明顯(P＜0.05),術後產婦拔管時間[(10.3±3.2)min]和睜眼時間[(15.4±2.3)min]Ⅰ組明顯早于Ⅱ組[(18.5±6.3)min,(25.6±3.5)min],差異有顯著性(P＜0.05).兩組新生兒1、5、10 min Apgar評分均大于7分,臍動脈血氣分析差異無顯著性(P＞0.05);兩組均未見新生兒呼吸抑製及產婦術中知曉髮生.結論 吸入七氟醚聯閤瑞芬太尼在剖宮產手術中的痳醉平穩、效果確切、囌醒快、新生兒無呼吸抑製.
목적 탐토칠불미복합서분태니재부궁산수술중적마취효과,병여이불미복합분태니비교.방법 장수부궁산수술적ASA Ⅰ～Ⅱ급적족월산부40례(23～32세)수궤분위칠불미복합서분태니조(Ⅰ조)화이불미복합분태니조(Ⅱ조)각20례.유도:Ⅰ조면조흡입3.5%칠불미、2～4 L/min류량적양기、정맥수입서분태니1μg/kg、병박분1 mg/kg、순분아곡고안0.1 mg/kg;Ⅱ조정맥주분태니0.02 mg/kg병박분2 mg/kg、순분아곡고안0.1 mg/kg.유지:Ⅰ조흡입1.5%～3.5%칠불미,태인면출후수주서분태니0.15μg/(kg·min);Ⅱ조흡입1%～2.5%이불미,태인면출후정맥주분태니0.02 mg/kg.취신생인제동맥(UA)혈양1 ml행혈기분석.분별기록량조마취기간혈류동역학적삼수、혈양포화도(SpO2)적변화、마취복소적시간、술중지효정황이급신생인Apgar평분、제동맥혈기분석.결과 Ⅰ조유도후화수술시심솔、혈압기본보지평은(P＞0.05).Ⅱ조재유도후심솔화혈압하강교Ⅰ조명현(P＜0.05),술후산부발관시간[(10.3±3.2)min]화정안시간[(15.4±2.3)min]Ⅰ조명현조우Ⅱ조[(18.5±6.3)min,(25.6±3.5)min],차이유현저성(P＜0.05).량조신생인1、5、10 min Apgar평분균대우7분,제동맥혈기분석차이무현저성(P＞0.05);량조균미견신생인호흡억제급산부술중지효발생.결론 흡입칠불미연합서분태니재부궁산수술중적마취평은、효과학절、소성쾌、신생인무호흡억제.
Objective To investigate the effects ofsevoflurane inhalation combined with iv injection ofremifentanil in cesarean section, and to compared with isoflurane combined with fentanyl. Methods Forty ASA Ⅰ～Ⅱ puerperas (23～32 years old) were randomly divided into 2 groups: sevoflurane group ( Ⅰ group) and isoflurane group ( Ⅱ group), 20cases for each group. Group Ⅰ was induced with mask inhalation of 3.5% of sevoflurane in 2～4 L/minutes oxygen and iv injection ofremifentanil 1 μ g/kg, propofol 1 mg/kg and benzene cisatracurium 0. 1mg/kg; group Ⅱ were induced with injectionoffentanyl 0.02mg/kg, propofol2mg/kgandbenzenecisatracurium0. 1 mg/kg. Anesthesiamaintenane: patients injection after foetus delivery; patientsin Ⅰ group were inspired 1.0%～2.5% isoflurane , then administrated fentanyl0.02mg/kg by intravenous injection after foetus delivery. Blood samples were taken from umbilical artery(UA) within 1 minute after the delivery of the baby for blood gas analysis. SBP, DBP, SPO2, HR, the anesthesia recovery time, the Apgar scores at 1,5 and 10 minutes after the delivery of the baby and the umbilical artery blood gas analysis results of these newborns were be recorded.Results The heart rate and the blood pressure in group Ⅰ maintain steady basically in induction and surgery(P ＞ 0.05). The heart rate and the blood pressure in group Ⅱ compare Ⅰ group obvious decreased after induction (P＜ 0.05).The time of extubation (10.3 ± 3.2) minutes and opening eyes (15.4 ± 2.3) minutes independently was obviously earlier in group Ⅰ than in group Ⅱ (18.5 ± 6.3) minutes, (25.6 ± 3.5) minutes after the surgery(P＜ 0.05).Apgar scores and umbilical artery blood gas analysis results of two groups were similar. (P＞ 0.05); There were no respiratory depression in the tow groups of newborns and no intraoperative awareness in the tow groups of maternal. Conclusion Anesthesia of sevoflurane inhalation combined with remifentanil is stable and effective and provide quick recovery for cesarean section. And there is no respiratory depression in the newborns.
