摘要
目的 研究地佐辛用于剖宫产术后硬膜外自控镇痛的安全性及其效果.方法 选取2013年5-7月广州市妇女儿童医疗中心择期蛛网膜下腔—硬膜外联合麻醉下行剖宫产术的产妇90例,完全随机分为3组,各30例.地佐辛Ⅰ组：地佐辛10 mg ＋0.1％左旋布比卡因＋0.9％氯化钠注射液共150 ml;地佐辛Ⅱ组：地佐辛20 mg ＋0.1％左旋布比卡因＋0.9％氯化钠注射液共150 ml;吗啡组：吗啡5 mg ＋0.1％左旋布比卡因＋0.9％氯化钠注射液共150 ml,行硬膜外镇痛.设置参数：持续背景剂量2 mL/h,单次给药量为2 ml/次,锁定时间20 min,记录开始镇痛后2、4、8、24、48 h的视觉模拟量表（VAS）评分和镇静（Ramsay）评分,观察镇痛效应及恶心呕吐、皮肤瘙痒、呼吸抑制等不良反应的发生情况.结果 术后地佐辛Ⅱ组、吗啡组2、4、8、24 h VAS评分均明显低于地佐辛Ⅰ组,差异有统计学意义[2 h：（3.0±0.9）、（3.1±1.0）分比（3.7±1.0）分;4 h：（3.2±0.7）、（3.2±0.8）分比（4.2±1.0）分;8 h：（3.1±0.7）、（3.2±0.9）分比（3.9±1.0）分;24 h：（2.3±0.7）、（2.4±0.8）分比（3.1±0.7）分]（P＜0.01）,而48 h3组比较差异无统计学意义（P＞0.05）,地佐辛Ⅱ组与吗啡组比较各时点VAS评分相当,差异无统计学意义（P＞0.05）;患者镇静满意度地佐辛Ⅱ组优于吗啡组（x2=6.857,P＜0.05）.术后不良反应地佐辛Ⅰ组为13.3％ （4/30）,地佐辛Ⅱ组为23.3％（7/30）,吗啡组为76.7％（23/30）,地佐辛Ⅰ组、地佐辛Ⅱ组与吗啡组比较,差异有统计学意义（P＜0.05）.结论 地佐辛复合左旋布比卡因剖宫产术后硬膜外自控镇痛安全有效,其中以地佐辛20 mg ＋0.1％左旋布比卡因＋0.9％氯化钠注射液共150 ml效果较好,不良反应较少.
Objective To explore the efficiency and safety of dezocine combined with levobupivacaine in patient controlled epidural analgesia after cesarean section.Methods Totally 90 patients undergoing patient controlled epidural analgesia after cesarean section from May to July 2013 were enrolled and randomly divided into dezocine Ⅰ group （dezocine 10 mg ＋ 0.1％ levobupivacaine 150 ml）,dezocine Ⅱ group （dezocine 20 mg ＋ 0.1％ levobupivacaine 150 ml） and morphine group （morphine 5 mg ＋0.1％ levobupivacaine）,30 cases in each group.The parameters of epidural analgesia were set as followed：continuous background dose 2 ml/h,single dose 2 ml/time,lockout time 20 min.The visual analogue scales （VAS） and sedation score standard （Ramsay score） were recorded 2,4,8,24 and 48 h after analgesia started,the adverse reactions such as nausea,vomiting,skin itching and respiratory depression were also recorded.Results The VAS scores in dezocine Ⅱ group and morphine group at 2,4,8,24 h were both lower than those in dezocine Ⅰ group [2 h：（3.0 ± 0.9）,（3.1 ± 1.0） scoresvs （3.7±1.0） scores;4h：（3.2±0.7）,（3.2±0.8） scores vs （4.2±1.0） scores;8 h：（3.1 ± 0.7）,（3.2±0.9） scores vs （3.9±1.0） scores;24 h：（2.3±0.7）,（2.4±0.8） scores vs （3.1 ±0.7） scores] （P ＜ 0.01）,but no statistical differences were observed at 48 h （P ＞ 0.05）.The VAS score in dezocine Ⅱ group had no difference at all points of time （P ＞ 0.05） compared with that in the morphine group.The degree of satisfaction in dezocine Ⅱ group was better than those in morphine group （x2 =6.857,P ＜ 0.05）.The incidence of adverse reactions after surgery in dezocine Ⅰ group and dezocine Ⅱ group was 13.3％ （4/30） and 23.3 ％ （7/30）,respectively,significantly lower than that in morphine group [76.7％ （23/30）] （P ＜ 0.05）.Conclusion Dezocine combined with levobupivacaine is safe and effective in patient controlled epidural analgesia after cesarean sec
出处
《中国医药》
2015年第5期693-696,共4页
China Medicine
关键词
硬膜外镇痛
地佐辛
左旋布比卡因
吗啡
剖宫产
Epidural analgesia
Dezocine
Levobupivacaine
Morphine
Cesarean section
