Comparison of remifentanil induction of general anesthesia in cesarean section of different anesthesia methods
10.3760/cma.j.issn.1673-4904.2013.30.011
- VernacularTitle:雷米芬太尼诱导行全身麻醉剖宫产术不同麻醉操作方法的对比研究
- Author:
Shihe CUI
;
Zhong JIANG
- Publication Type:Journal Article
- Keywords:
Anesthesia,general;
Cesarean section;
Remifentanil
- From:
Chinese Journal of Postgraduates of Medicine
2013;36(30):28-31
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the feasibility of reducing induction dose of remifentanil,deepening anesthesia and intubation after umbilical removal and its effect on maternal,neonatal and anesthesiologists during cesarean section.Methods Thirty cases of ASA Ⅰ-Ⅱ scheduled for elective cesarean section were divided into three groups according random digits table method with 10 cases each.The induction dose of remifentanil was 1.0,1.5,1.0 μ g/kg in group Ⅰ,group Ⅱ,group Ⅲ.Group Ⅰ and group 11 received routine procedure after induction of anesthesia,intubation,while group Ⅲ received anesthesia umbilical removal.Systolic pressure (SBP),diastolic pressure (DBP) and heart rate (HR) were recorded before induction of anesthesia,skin incision and immediately intubation.And the fetal childbirth time,intubation time and neonatal Apgar score at 1,5,10 min were recorded.Results Three anesthesia procedures could meet the requirements of cesarean section.The SBP,DBP and HR at skin incision in group Ⅰ and group Ⅲ were significantly higher than those at before induction of anesthesia [group Ⅰ:(136.5 ±9.7) mm Hg (1 mm Hg=0.133 kPa) vs.(113.5 ±7.8) mm Hg,(96.5 ±9.1) mm Hg vs.(74.2 ±6.0)mm Hg,(98.5 ± 8.7) times/min vs.(81.2 ± 8.4) times/min; group Ⅲ:(138.1 ± 11.4) mm Hg vs.(118.7 ±9.9) mm Hg,(90.1 ±9.9) mm Hg vs.(77.3 ±7.9) mm Hg,(100.3 ±9.0) times/min vs.(81.7 ±9.2)times/min],there were statistical differences (P ＜ 0.05).The SBP,DBP and HR at immediately intubation in group Ⅲ were significantly lower than those in group Ⅰ andgroup Ⅱ [(97.6±10.1)mmHgvs.(138.9±11.2) and (130.1 ± 4.5) mm Hg,(80.1 ± 5.5) mm Hg vs.(97.7 ± 8.9) and (82.0 ± 8.6) mm Hg,(80.4 ±7.8) times/min vs.(99.3 ± 12.2) and (95.9 ± 9.6) times/min],there were statstical differences (P ＜ 0.05).There was no statistical difference in fetal childbirth time among the 3 groups (P＞ 0.05).The neonatal Apgar score at 1 min in group Ⅱ was significantly lower than that in group Ⅰ and group Ⅲ [(7.4 ± 0.9) scores vs.(8.8 ± 0.6),(8.9 ± 0.6) scores],there was statistical difference (P ＜ 0.05).The intubation time in group Ⅲ was significantly longer than that in group Ⅰ andgroup Ⅱ [(8.5±l.8) min vs.(3.0±0.5),(2.8±0.6)min],there was statistical difference (P＜ 0.05),but the intubation time in group Ⅲ was completed within 10 min.Conclusions Using the protocol of remifentanil 1.0 p g/kg induction,midazolam 2 mg,fentanyl 0.2 mg deepening after the umbilical removal can effectively avoid the effect of remifentanil on neonatal 1 min Apgar score,decrease the intubation stress with no effect on anesthesiologists.This method is simple,method of anesthesia for elective cesarean section.
