摘要
目的观察静脉右美托咪啶在腰麻剖宫产术患者中对布比卡因阻滞时间的影响。方法将择期行剖宫产术的ASAⅠ或Ⅱ级50例产妇随机分为右美托咪啶组(DEX组)和0.9%氯化钠溶液组(NS组)。蛛网膜下腔穿刺给予0.5%布比卡因8 mg,胎儿娩出10 min后,DEX组予右美托咪啶1μg/kg,10 min输完后改为0.5μg/(kg·h)持续静注,NS组予等量0.9%氯化钠溶液静注直至术毕。记录腰麻布比卡因起效时间,感觉和运动阻滞持续时间,Ramsay镇静评分,记录胎儿娩出前(T0)、娩出后10 min(T1),试验药物给药后10 min(T2)、20 min(T3)、30 min(T4)的MAP和HR。记录药物不良反应发生率和新生儿Apgar评分。结果 DEX组的感觉和运动阻滞持续时间与NS组相比均显著延长(P<0.05)。DEX组的Ramsay镇静评分显著高于NS组(P<0.05),DEX组T2的HR明显低于NS组(P<0.05),DEX组中有6例(24%)发生心动过缓。结论在腰麻剖宫产术患者中静脉泵注右美托咪啶,可以显著延长布比卡因的感觉和运动阻滞持续时间,提供满意的镇静效果,主要不良反应为心动过缓,对血流动力学和新生儿Apgar评分无明显影响。
Objective To investigate the effects of intravenous dexmedetomidine on block duration of subarachnoid bupivacaine in patients undergoing cesarean section. Methods Fifty parturients of ASAⅠorⅡscheduled for caesarean section were randomly allocated to two groups： dexmedetomidine group（ DEX group） and normal saline group（ NS group）. All parturients received 0. 5% hyperbaric bupivacaine 8 mg intrathecally. Ten mins after delivery,DEX group received dexmedetomidine 1 μg / kg bolus infusion for 10 mins followed by 0. 5 μg /（ kg·h） continuous infusion until end of surgery,whereas NS group were infused equivalent amount of volume. The onset time,sensory and motor block duration of subarachnoid bupivacaine,Ramsay score,MAP and HR of timepoint of before delivery（ T0）,10 mins after delivery（ T1）,10 mins（ T2）,20 mins（ T3） and 30 mins（ T4） after study drug infusion were recorded respectively. The incidence of drug adverse effect and Apgar score were also recorded. Results The sensory and motor block duration of DEX group were significantly prolonged compared with NS group（ P〈0. 05）. Ramsay score of DEX group was higher than that of NS group（ P〈0. 05）,and the HR of T2 of DEX group was lower than that of NS group（ P〈0. 05）. Six patients（ 24%） in DEX group experienced bradycardia. Conclusions Intravenous dexmedetomidine could significantly prolong the sensory and motor block duration of subarachnoid bupivacaine in patients undergoing cesarean section,and in the meantime provide satisfactory sedation without any obvious influence on parturient hemodynamics and neonate Apgar score. The primary adverse effect observed is bradycardia.
出处
《基础医学与临床》
CSCD
2016年第6期826-829,共4页
Basic and Clinical Medicine
关键词
右美托咪啶
布比卡因
腰麻
剖宫产术
dexmedetomidine
bupivacaine
spinal anesthesia
cesarean section
