Abstract: ［Abstract］ Objective〖HTSS〗〓To explore the most appropriate concentration of remifentanil targeted infusion in schizophrenia pregnant women underwent cesarean delivery and the impact on mothers and babies.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Selected 60 cases of general anesthesia cesarean section schizophrenia primipara were randomly divided into lowdose group(remifentanil 2.0 μg/L), middledose group(remifentanil 3.0 μg/L) and highdose group(remifentanil 4.0 μg/L). With tracheal intubation, remifentanil is administered to target plasma concentrations, with propofol 2.0 mg/kg intravenously, rocuronium 0.6 mg/kg intravenously. The following parameters were recorded: the systolic blood pressure before the induction of anesthesia(T1), immediately after tracheal intubation(T2), incision(T3), immediately before the baby was delivered(T4)，closing the abdomen(T5), systolic arterial pressure(SBP), diastolic blood pressure(DBP) and heart rate(HR), the operation time and the amount of propofol, the recovery time and extubation time at the end of surgery. The Apgar scores of 1 min and 5 min neonates after birth and neonatal neurobehavioral score of 1 h and 24 h were recorded respectively.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓Compared with T1, systolic blood pressure, diastolic blood pressure and heart rate were increased gradually at T2, T3, T4 and T5 in lowdose group, while SBP, DBP and HR were decreased gradually in middledose and highdose groups, but there was a small fluctuation in T3 and T4. There were significant differences in the SBP and HR in the three groups and among intergroups·time interaction(P＜005). However, there were significant differences in the DBP interaction in the three groups, time points and intergroups·time interaction(P＜005). The middledose group and highdose group had longer eye opening time and extubation time than those in the lowdose group, the extubation time was longer in the highdose group than that in the middledose group, The dosage of propofol in the highdose group was lower than that in the lowdose group and middledose group, the difference was statistically significant(P＜005). The neonatal 1 min and 5 min Apgar scores after birth and the neonatal behavioral neurological assessmen scores at 1 h and 24 h after birth in highdose group were lower than that in the lowerdose and middledose groups(P＜005). Remifentanil blood concentration(remifentanil) in maternal radial artery and neonatal umbilical vein in the middledose group and the highdose group were higher than that in the lowdose group(P＜005). Remifentanil in maternal radial artery and neonatal umbilical vein in highdose group were higher than that in the middledose group(P＜005). Rremifentanil in neonatal umbilical artery in the middledose group and highdose group was higher than that in the lowdose group. Remifentanil ratio of neonatal umbilical artery/maternal radial artery in the middledose group and highdose group was higher than the lowdose group, remifentanil ratio of neonatal umbilical artery/neonatal umbilical vein in highdose group was lower than the lowdose group, the difference was statistically significant(P＜005).
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Remifentanil combined with propofol has a synergistic effect. As the dose of remifentanil increases, the dose of remifentanil increases through the placenta into the fetus. The appropriate plasma target concentration for remifentanil is 3.0 μg/L for schizophrenia pregnant women underwent cesarean section.

Key words: schizophrenia; , cesarean section, remifentanil