Effects of combined spinal epidural anesthesia and general anesthesia in cesarean section for pediatric ;respiration / 中国基层医药

ABSTRACT

Objective To compare the effect of combined spinal epidural anesthesia and general anesthesia for cesarean section surgery on pediatric respiration,discuss the choice of anesthesia in caesarean operation.Methods 140 cases of maternal line cesarean section were randomly divided into control group and observation group,70 cases in each group.Control group used propofol,sufentanil and cis atracurium intravenous induction,after fetal take out used conventional medicine.The observation group used combined spinal epidural anesthesia with ropivacaine.Recor-ded the operation time,cut skin to fetal childbirth time and uterine incision to fetal childbirth time.Fetal umbilical arterial blood for blood gas analysis,compared the two groups of Apger score at 1min,5min,10min after birth,the first breath of time,and the use of auxiliary breathing,chest compressions and total drug recovery.Results The operation time,cut skin to take time out and uterine incision to fetus fetus in the two groups had no statistical differences(t =0.974,P =0.332;t =0.067,P =0.947;t =0.803,P =0.423).Apger score at 1min in the observation group [(8.91 ±0.75)min]was better than the control group[(9.26 ±0.86)min](t =-2.566,P =0.011),while Apger score between the two groups at 5min,10min had no statistically significant differences(t =-0.533,P =0.595;t =-0.299,P =0.765).The pediatric first breath[(7.17 ±3.26)s]of the observation group was shorter than the control group[(21.34 ±5.75)s](t =17.936,P <0.001).pH,PaCO2 ,PaO2 in umbilical artery blood of the two groups had no statistically significant differences(t =-0.438,P =0.662;t =0.102,P =0.919;t =-0.524,P =0.601).In the observation group used auxiliary breathing,chest compressions and drug recovery in all 7 cases,which was less than 15 cases in the control group,but there was no statistically significant difference (χ2 =3.451,P =0.063).Conclusion The effect of combined spinal epidural anesthesia for cesarean section in pediatric breathing is smaller,it can be used in a cesarean section safely,and worth popularizing in clinical application.