摘要
目的观察纳布啡联合瑞芬太尼静脉自控于剖宫产术后的镇痛效果。方法选取2017年6月-2019年6月剖宫产手术的产妇100例为研究对象,随机分为观察组和对照组,每组50例。观察组采用纳布啡联合瑞芬太尼静脉自控镇痛,对照组仅采用瑞芬太尼静脉自控镇痛,比较2组术后镇痛、镇静效果及应激反应和不良反应。结果术后6 h,观察组VAS疼痛量表评分低于对照组(P <0. 01);术后1、24 h,2组疼痛评分比较差异无统计学意义(P> 0. 05)。术后1 h,2组Ramsay镇静程度评分比较差异无统计学意义(P> 0. 05);术后6、24 h,观察组Ramsay镇静程度评分高于对照组(P <0. 01)。术后,2组血清催乳素(PRL)、血清皮质醇(Cor)水平较术前均显著改善,且观察组血清PRL水平高于对照组,Cor水平低于对照组(P <0. 01)。2组不良反应发生率比较差异无统计学意义(P>0. 05)。结论纳布啡联合瑞芬太尼静脉自控的剖宫产产妇,术后镇痛效果显著,改善应激反应,且镇静程度持续时间长,值得临床推广应用。
Objective To observe the effect of nalbuphine combined with remifentanil on intravenous controlled analgesia after cesarean section. Methods One hundred women who underwent cesarean section from June 2017 to June 2019 were randomly divided into observation group and control group,with 50 cases in each group. The observation group used nalbuphine combined with remifentanil for intravenous analgesia,and the control group only used remifentanil for intravenous analgesia. The analgesic,sedative effects,stress reactions and adverse reactions of the two groups were compared. Results At6 h after surgery,the VAS pain scale score in the observation group was lower than that in the control group( P < 0. 01). At1 and 24 hours after surgery,there was no significant difference in pain scores between the two groups( P > 0. 05). There was no significant difference in Ramsay sedation score between the two groups at 1 h after surgery( P > 0. 05). At 6 and 24 hours after surgery,the sedation score of Ramsay in the observation group was higher than that in the control group( P < 0. 01).Postoperatively,the levels of serum prolactin( PRL) and serum cortisol( Cor) in both groups were significantly improved compared with before surgery,and the serum PRL level in the observation group was higher than that in the control group,and the Cor level was lower than that in the control group( P < 0. 01). There was no significant difference in the incidence of adverse reactions between the two groups( P > 0. 05). Conclusion Nabuphine combined with remifentanil intravenous self-control for cesarean delivery has significant analgesic effects,can improve its stress response,and has a long duration of sedation,which is worthy of clinical popularization.
作者
林春发
LIN Chunfa(Department of Anesthesiology,Fu'an Hospital,Fujian Province,Fu'an City 355001,China)
出处
《临床合理用药杂志》
2019年第35期24-25,28,共3页
Chinese Journal of Clinical Rational Drug Use
关键词
纳布啡
瑞芬太尼
剖宫产
静脉自控镇痛
Nabufine
Remifentanil
Cesarean section
Intravenous analgesia
