瑞芬太尼无痛分娩对新生儿PH值影响.docVIP

瑞芬太尼无痛分娩对新生儿PH值影响 　　【摘要】目的：探讨瑞芬太尼在无痛分娩麻醉诱导中对新生儿的影响。方法：选取我院收治的行腰硬联合阻滞麻醉无痛分娩的产妇60例，将所有产妇随机分为观察组和对照组，每组30例。对照组患者在分娩过程给予0.9%生理盐水；观察组患者在分娩过程中给予瑞芬太尼0.1μg/kg?min。对两组1、5min的Apgar评分、母体动脉血、脐动脉血和脐静脉血进行观察。结果：两组产妇分娩新生儿1、5min的Apgar评分均无明显性差异（P＞0.05）；观察组产妇pH值明显低于对照组（P＜0.05）；观察组脐静脉血pH值明显低于对照组（P＜0.05）。结论：在无痛分娩中采用瑞芬太尼进行麻醉诱导，能降低新生儿pH值，但对胎儿没有影响。 　　【关键词】瑞芬太尼；无痛分娩；新生儿；PH值 　　 　　Influence of remifentanil on PH value of newborn at painless childbirth 　　 　　[Abstract] Objective: To investigate the influence of remifentanil on the newborn at painless childbirth. Methods: 60 cases of puerperal with lumbar epidural anesthesia at painless childbirth were selected. Patients were randomly were randomly divided into observation group and control group, 30 cases in each group. Patients in control patients were given 0.9% saline at painless childbirth, and patients in observation group were given remifentanil 0.1μg/kg#8226;min. Apgar scores at1 and 5 min, and blood gas analysis of maternal arterial, umbilical artery and umbilical cord blood of two groups were observed. Results: There was not significantly different on 1,5 min Apgar scores of maternity newborn in two groups (P 0.05); maternal pH of observation group was significantly lower than the control group (P 0.05); umbilical cord blood pH of observation group was significantly lower than the control group (P 0.05). Conclusion: In painless childbirth，Using remifentanil anesthesia induction can reduce the PH of newborn, but has no influence to newborn. 　　[Key words] remifentanil; painless childbirth; newborn; umbilical artery; PH value 　　 　　产妇在全身麻醉下进行无痛分娩手术过程中，为避免新生儿呼吸受到抑制，一般严禁使用中长效麻醉性镇痛药。为了满足手术对产妇镇静效果的要求，单纯的镇静药物一般用药剂量较大，从而导致产妇在手术过程中明显的应激反应。瑞芬太尼作为一种短效麻醉性镇痛药，其不仅镇痛效果明显、起效快，而且体内代谢较快，长期输注不存在明显蓄积作用。近年来，该药在全麻剖宫产中的安全性得到广泛的证实，但对新生儿的影响相关报道很少。本研究采用瑞芬太尼进行麻醉诱导，通过对产妇和新生儿的脐动脉、脐静脉进行血气分析，探讨瑞芬太尼对新生儿的影响[1-2]。 　　 　　1.资料与方法 　　1.1一般资料 　　选取我院收治的足月的产妇60例，年龄24～36岁，平均（30.4±4.6）岁，孕周37～40周，所有患者均行腰硬联合阻滞麻醉无痛分娩术。将所有产妇随机分为观察组和对照组，每组30例，对照组产妇采用常规麻醉，观察组采用瑞芬太尼诱导麻醉。排除标