摘要
目的探讨不同剂量甲氧明预防性泵注对蛛网膜下腔阻滞麻醉剖宫产产妇血流动力学及新生儿的影响。方法择期蛛网膜下腔阻滞麻醉剖宫产孕妇80例,随机分为4组各20例。M1组、M2组、M3组术前分别将2、4、6mg甲氧明加入生理盐水配成20mL溶液,并于麻醉穿刺成功即刻以0.1、0.2、0.3mg/min速率泵注,对照组不泵注任何药物。记录4组产妇入室时(基础值)、麻醉后1、3min,胎儿娩出时,胎儿娩出后1、3min及术毕血压、心率变化,观察术中低血压、恶心呕吐、心动过缓等不良反应发生情况,记录新生儿Apgar评分及脐静脉血气指标。结果 M1组、M2组、M3组、对照组麻醉后1min时收缩压(systolic blood pressure,SBP)[(106.8±9.6)、(111.2±12.8)、(109.8±11.3)、(107.1±16.5)mm Hg]均较基础值[(119.8±7.8)、(121.5±8.9)、(116.8±8.9)、(123.4±8.1)mm Hg]下降(P<0.01),M1组、M3组、对照组麻醉3min时SBP[(99.4±8.7)、(104.0±15.2)、(99.5±11.6)mm Hg]低于麻醉后1min(P<0.05),M1组、M2组、M3组、对照组术毕SBP[(109.4±7.1)、(113.6±9.0)、(111.2±7.6)、(109.9±7.7)mm Hg]均低于基础值(P<0.01);麻醉后1min,M1组、对照组心率较基础值增高(P<0.01),M3组心率较基础值下降(P<0.05),M2组心率与基础值比较差异无统计学意义(P>0.05),胎儿娩出后1min,仅对照组心率较胎儿娩出时增高(P<0.01);M1组、M2组分娩前低血压发生率(30%、15%)低于对照组(70%),M2组恶心呕吐发生率(5%)低于对照组(40%),M3组心动过缓发生率(40%)高于对照组(0),差异均有统计学意义(P<0.05);4组新生儿Apgar评分以及脐静脉血pH、pa(O_2)、pa(CO_2)比较差异无统计学意义(P>0.05)。结论术前以0.2mg/min速率泵注甲氧明可有效预防剖宫产患者麻醉后低血压,且血流动力学平稳,新生儿Apgar评分及脐静脉血气指标稳定。
Objective To explore the clinical effects of different doses of methoxamine infusion with micro-pump prophylacticly on parturient hemodynamics and neonate during spinal anesthesia for caesarean delivery.Methods Eighty cases of elective cesarean section were randomly divided into four groups：methoxamine groups（M1,M2,and M3groups）and control group,with 20 cases in each group.M1,M2,and M3 groups were added 2,4 and 6 mg methoxamine into normal saline to prepare 20 mL solution,and were infused at the speeds of 0.1,0.2and 0.3mg/min immediately after lumbar puncture success.Control group received no preventive intervention.The blood pressure and heart rate were recorded upon entering the operating room,in 1,3and 5min after spinal anesthesia,after delivery,1and3 min after delivery,and after operation.The incidences of adverse reactions including hypotension,nausea and vomiting,and bradycardia were observed.The neonatal Apgar score and umbilical vein blood gas indexes were recorded.Results Systolic blood pressures were significantly lower in 1min after anesthesia in M1,M2 and M3 groups and control group（（106.8±9.6）,（111.2±12.8）,（109.8±11.3）,（107.1±16.5）mm Hg）than those upon entering the operating room（（119.8±7.8）,（121.5±8.9）,（116.8±8.9）（123.4±8.1）mm Hg）（P〈0.01）,and significantly lower in 3min after anesthesia（（99.4±8.7）,（104.0±15.2）,（99.5±11.6）mm Hg）than those in 1min after anesthesia in M1 group,M3group and control group（P〈0.05）.Systolic blood pressures after operation were significantly lower in M1,M2,M3 and control group（（109.4±7.1）,（113.6±9.0）,（111.2±7.6）,（109.9±7.7）mm Hg）than those upon entering the operating room（P〈0.01）.The heart rates in 1min after anesthesia were significantly higher in M1 and control groups than those upon entering the operating room（P〈0.01）,the heart rate was significantly lower in M3 group than that upon entering the operating room（P〈0.05）,and there was no significant
出处
《中华实用诊断与治疗杂志》
2016年第4期409-411,共3页
Journal of Chinese Practical Diagnosis and Therapy
