喉罩下七氟醚吸入全身麻醉在剖宮產(chǎn)術(shù)中的應(yīng)用.pdf

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1、38南昌大學(xué)學(xué)報(bào)(醫(yī)學(xué)版)2013年第53卷第9期JournalofNanchangUniversity(MedicalSciences)2013，Vo1．53No．9喉罩下七氟醚吸入全身麻醉在剖宮產(chǎn)術(shù)中的應(yīng)用郭善亮，張明生，周緒峰(江西省人民醫(yī)院麻醉科，南昌330006)摘要：目的探討喉罩下七氟醚吸入全身麻醉應(yīng)用于剖宮產(chǎn)術(shù)的麻醉效果及其安全性。方法選擇擬行剖宮產(chǎn)術(shù)有椎管內(nèi)麻醉禁忌證的4O例產(chǎn)婦為研究對(duì)象，按入院順序分別納入s組(一2O，喉罩下七氟醚吸人全身麻醉)和R組(：20，氣管插管全身麻醉)。記錄2組產(chǎn)婦人室時(shí)(TO)、插管或置人喉罩時(shí)(T1)、切皮時(shí)(T2)、拔管或拔喉罩時(shí)(T3)的

2、生命體征、胎兒娩出時(shí)間、停藥至拔管時(shí)間、手術(shù)時(shí)間和蘇醒時(shí)間；記錄產(chǎn)婦術(shù)中，術(shù)后2、6、24h內(nèi)總出血量；記錄新生兒出生1、5rain的Apgar評(píng)分及出生3、5d的神經(jīng)行為能力(NBNA)評(píng)分，并對(duì)所得數(shù)據(jù)進(jìn)行分析。結(jié)果2組產(chǎn)婦TO生命體征比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P>0．05)。S組T1、T3HR、MAP均顯著低于R組(PO．05)。結(jié)論喉罩下七氟醚吸入全身麻醉可安全應(yīng)用于有椎管內(nèi)麻醉禁忌產(chǎn)婦的剖宮產(chǎn)術(shù)，對(duì)產(chǎn)婦刺激小，淺

3、麻醉下可耐受，產(chǎn)婦生命體征平穩(wěn)，術(shù)后拔管及蘇醒時(shí)間短，蘇醒質(zhì)量高，新生兒無(wú)呼吸抑制。關(guān)鍵詞：喉罩；七氟醚；剖宮產(chǎn)；椎管內(nèi)麻醉禁忌證；全身麻醉中圖分類號(hào)：R726．1文獻(xiàn)標(biāo)志碼：A文章編號(hào)：2095—4727(2013)09—0038—03ApplicationofSevofluraneGeneralAnesthesiaviaLaryngealMaskAirwayinCaesareanSectionGUOShan。liang，ZHANGMing-sheng，ZHOUXu。feng(DepartmentofAnesthesia，JiangxiProvincialPeople’SHospital，

4、Nanchang330006，China)ABSTRACT：ObjectiveToinvestigatetheefficacyandsafetyofsevofluranegeneralanesthesiavialaryngealmaskairwayincaesareansection．MethodsFortyparturientwomenwithcontrain—dicationtospinalcanalanesthesiawhowerescheduledforcaesareansectionwererandomlyas—signedtoreceiveeithersevofluranegen

5、eralanesthesiavialaryngealmaskairway(groupS，n一20)orgeneralanesthesiaviatrachealintubation(groupR，n=2O)．Vitalsigns，deliverytime，extuba—tiontimeandrecoverytimewererecordedatadmission(TO)，intubationorlaryngealmaskinser—tion(T1)，skinincision(T2)，andextubationorlaryngealmaskremoval(T3)．Maternalbloodloss

6、wasmeasuredwithin2，6and24hoursafteroperation．Inaddition，infantApgarscoresweredetermined1and5minutesafterbirthandneonatalbehavioralneurologicalassessment(NBNA)scoreswererecorded3and5daysafterbirth．ResultsTherewerenosignificantdifferencesinvi—talsignsbetweenthetwogroupatTO(P>O．05)．ComparedwithgroupR，

7、heartrate，meanarte—rialpressure，extubationtimeandrecoverytimesignificantlydecreasedingroupSatT1andT3(P<0．05)．Nosignificantdifferencesindeliverytime，operationduration，maternalbloodlOSS，ApgarscoresandNBNAscor