摘要
目的观察右美托咪定辅助舒芬太尼应用于剖宫产手术术后镇痛的效果。方法选择ASAⅠ或Ⅱ级择期剖宫产手术患者90例,随机均分为三组：Ⅰ组术后镇痛给予舒芬太尼1.5μg·kg-1,Ⅱ组舒芬太尼1.0μg·kg-1,Ⅲ组舒芬太尼1.0μg·kg-1＋右美托咪定1.0μg·kg-1。术毕均给予负荷剂量3 m L,镇痛泵设置为2 m L/h,锁定时间间隔15 min,单次负荷剂量2 m L。采用BCS评价疼痛程度,Ramsay评分评估镇静程度,记录三组术毕（T1）及术后6 h（T2）、12 h（T3）、24 h（T4）与48 h（T5）的疼痛程度和镇静评分,记录各时间段自控镇痛有效按压次数,记录不良反应发生率以及MAP、HR、Sp O2。结果 T2~T5时Ⅲ组BCS评分显著高于Ⅰ、Ⅱ组（P〈0.05）;Ⅱ组自控有效按压次数明显多于Ⅰ、Ⅲ组（P〈0.05）。Ⅰ组恶心、呕吐、皮肤瘙痒发生率高于Ⅱ、Ⅲ组（P〈0.05）。Ⅲ组HR显低于Ⅰ、Ⅱ组（P〈0.05）,Ramsay评分明显高于Ⅰ、Ⅱ组（P〈0.05）。结论右美托咪定用于剖宫产手术术后镇痛可减少舒芬太尼用量,提高舒适度,同时降低恶心、呕吐、皮肤瘙痒的发生率,但心动过缓发生率增高。
Objective To observe the effects of dexmedetomidine combined with sufentanil in postoperative analgesia of cesarean section. Methods 90 cases of selective cesarean section at ASA Ⅰ or Ⅱ were randomly divided into three groups, with 30 cases in each group. After surgery, group Ⅰ was given sufentanil 1.5 μg·kg-1, group Ⅱ was given sufentanil 1.0 μg·kg-1, while group Ⅲ was given sufentanil 1.0 μg·kg-1combined with dexmedetomidine 1.0 μg·kg-1. Loading dose was 3 m L, analgesia pump was 2 m L/h, lock interval was15 min, and single loading dose was 2 m L. BCS was used to evaluate the pain degree, and Ramsay score was used to evaluate the sedation degree. The pain degrees and sedation scores were evaluated at the end of surgery（T1）, 6 h after surgery（T2）, 12 h after surgery（T3）, 24 h after surgery（T4）, and 48 h after surgery（T5）. The effective pressing numbers of patient-controlled analgesia during each time quantum were recorded, and the incidences of adverse reactions, and MAP, HR, Sp O2 levels were recorded. Results At T2, T3, T4 and T5, the BCS scores of group Ⅲ were significantly higher than those of group Ⅰ and group Ⅱ（P〈0.05）, and the effective pressing numbers of patient-controlled analgesia of group Ⅱ were significantly more than those of group Ⅰ and group Ⅲ（P〈0.05）. The incidences of nausea, vomiting, and pruritus of group Ⅰ were significantly higher than those of group Ⅱ and group Ⅲ（P〈0.05）. The HR of group Ⅲ were significantly lower than those of group Ⅰ and group Ⅱ（P〈0.05）, and Ramsay scores were significantly higher than those of group Ⅰ and group Ⅱ（P〈0.05）.Conclusions Dexmedetomidine used in postoperative analgesia of cesarean section can reduce the usage amount of sufentanil, improve maternal comfort degree and reduce the incidences of nausea, vomiting, and pruritus, but the incidence of bradycardia is relatively high.
出处
《临床医学工程》
2015年第3期296-297,300,共3页
Clinical Medicine & Engineering
关键词
术后镇痛
剖宫产
右美托咪定
Postoperative analgesia
Cesarean section
Dexmedetomidine
