不同体位腰硬联合麻醉对剖宫产孕妇血流动力学影响.docVIP

不同体位腰硬联合麻醉对剖宫产孕妇血流动力学的影响 　　【摘要】 目的 观察不同体位腰硬联合麻醉(CSEA)对剖宫产孕妇血流动力学的影响。方法 选择行剖宫产孕妇132例,随机分为坐位组和侧卧位组各66例,坐位组于坐位下注药,3 min后平卧;侧卧位组按传统方法注药。结果 坐位组一次性穿刺成功率98.5%明显高于侧卧位组84.9%(P0.01);坐位组最高麻醉平面在T6～T8,侧卧位组则在T3～T8;坐位组与侧卧位组麻醉平面达T8水平的时间分别为给药后6 min、3 min,稳定在最高麻醉平面的时间分别为7 min、12 min;坐位组需用麻黄素者7.8%,明显低于侧卧位组的22.7%(P0.01)。结论 两组均可获得满意的麻醉效果,但坐位组比侧卧位组会更具有优势,在临床上坐位CSEA麻醉具有广阔的应用前景。 　　【关键词】 腰硬联合麻醉;剖宫产;体位 　　 　　Effect of different postures on hemodynamics during cesarean section under combined spinal-epidural anesthesia 　　 　　ZHAI Li-li,ZHUANG Zhao-ji,LIN Ya-li,et al. 　　The First Affiliated Hospital of Guangxi Traditional Chinese Medicine University, Nanning,530023,China 　　 　　【Abstract】 Objective To explore the effect of different postures on hemodynamics during cesarean section under combined spinal-epidural anesthesia(CSEA).Methods 132 patients underment cesarean section were selected and randomly divided into sitting position group(66 patients)and lateral decubitus position group(66 patients),the patients in sitting position group were given medicine in sitting position and took horizontal position after three minutes; The patients in lateral decubitus position group were given medicine routinely.Results The one-time success rate of puncture in sitting position group(98.5%) was higher than that of in lateral decubitus position group(84.9%)(P0.01);The level of anesthesia in sitting position group was T6~T8 ,it was T3~T8 in lateral decubitus position group;The time of anesthetic plane to the T8 were 6 minutes and 3 minutes respectively, stabilized time were 7 minutes and 12 minutes respectively in sitting position group and lateral decubitus position group; 7.8% patients in sitting group used ephedrine and 22.7% patients in lateral decubitus position group,the difference was significant(P0.01).Conclusion The patients of two groups all receive satisfied anesthetic effect,but sitting position group has more effective so combined spinal-epidual anesthesia with sitting postion have rast ap