【摘要】 目的观察瑞芬太尼复合丙泊酚行无正压通气诱导在5分钟剖宫产中对产妇血流动力学及新生儿Apgar评分的影响。方法选择2014年8月至2016年1月,我院启动5 min剖宫产产妇60例,年龄23~38岁,体重55~80 kg,孕周38~40周。随机分为两组:瑞芬太尼1μg/kg复合丙泊酚2 mg/kg组(R组)和氯胺酮0.5 mg/kg复合丙泊酚2 mg/kg组(L组),每组30例。记录麻醉诱导插管(T1)、切皮(T2)、胎儿取出断脐时(T3)产妇SBP、DBP、HR及不良反应发生情况;记录胎儿娩出时间及胎儿娩出时脐动脉血气,以及新生儿1 min和5 min的Apgar评分。结果 T1、T2时L组SBP、DBP明显高于R组,HR明显快于R组(P<0.05),T3时两组HR、SBP、DBP差异无统计学意义。两组脐动脉血气分析差异无统计学意义。两组胎儿娩出时间,新生儿1 min和5 min的Apgar评分差异均无统计学意义。结论瑞芬太尼复合丙泊酚联合无正压通气诱导技术在5分钟全麻剖宫产中产妇血流动力学波动轻微,不增加胎儿/新生儿呼吸抑制的风险,可行性好,对母婴安全可靠。更多还原

【Abstract】 Objective To study the effects of remifentanil with propofol and no positive pressure ventilation induction of anesthesia in 5 minutes-cesarean section on parturients and neonates. Methods Sixty pregnant women were randomly divided into ketamine anesthesia group( group L) and remifentanil anesthesia group( group R). In group L,anaesthesia was induced with ketamin 0. 5 mg / kg + propofol 2 mg / kg and group R with remifentanil 1 μg / kg + propofol 2 mg / kg. Blood pressure,heart rate,oxygen saturation and pulse rate of maternal were recorded at intubation( T1),incision( T2),and cutting the umbilical cord( T3). The infant Apgar scores at 1 minute and 5 minute after birth,the delivery time of the fetus and umbilical blood gas values were recorded. Results The systolic blood pressure( SBP) and heart rate( HR)were significantly higher at T1 and T2in group L than those in group R( P < 0. 05). The SBP,DBP and HR had not significant difference at T3. The delivery time of the fetus and the infant Apgar scores at 1 minute and 5 minute between the two groups had no statistically significant differences. Conclusion Remifentanil combined with propofol and without positive pressure ventilation induction of anesthesia can be safely used in5 minutes-cesarean section. The maternal hemodynamics is more stable without increasing the risk of neonatal respiratory depression.更多还原