摘要
目的探讨布托啡诺用于分娩镇痛产妇皮肤瘙痒的临床价值。方法选取2017年12月1日~2019年6月30日本院收治住院分娩要求实施分娩镇痛且出现明显皮肤瘙痒孕妇40例,所有入组产妇存在进入第一产程后即开始实施硬膜外分娩镇痛,针对瘙痒产妇,给与布托啡诺,最高剂量不超过4mg/24h。比较干预前后患者瘙痒情况,疼痛NRS评分及舒适度评分,统计干预过程中出现的不良反应、瘙痒控制时间及瘙痒复发例数。结果干预后患者无瘙痒比例显著高于干预前(χ^2=36.753,P<0.05),轻度瘙痒比例高于干预前(χ^2=4.781,P<0.05),中度及重度瘙痒比例显著低于干预前(χ^2=20.570、6.328,P均<0.05),干预后疼痛NRS评分显著低于干预前(t=46.978,P<0.05),舒适度评分显著高于干预前(t=56.569,P<0.05),干预过程中发生困倦、嗜睡、低血压、恶心呕吐、头晕各1例,均经对症支持处理及加强观察后好转,瘙痒控制时间为(23.1±1.6)min,24h内瘙痒复发例数为1例。结论针对应用阿片类受体激动剂分娩镇痛后出现瘙痒产妇,使用布托啡诺,能有效的控制瘙痒,缓解患者疼痛,提高治疗舒适度,且起效快,治疗后不良反应少。
Objective To explore the clinical value of butorphanol in pruritus of parturient analgesia women.Methods 40 pregnant women admitted to our hospital and required labor analgesia and showed obvious skin itching from December 1,2017 to June 30,2019 were selected and started to implement epidural labor analgesia after entering the first stage of labor.Butorphanol was given to pruritus parturient women with a maximum dose of no more than 4mg/24h.The itching condition,pain NRS score and comfort score of the patients before and after the intervention were compared,and the adverse reactions,itch control time and the number of itch recurrence cases during the intervention were counted.Results The proportion of patients without pruritus and mild pruritus after intervention were significantly higher than those before intervention(χ^2=36.753,4.781,P<0.05),the proportion of moderate and severe itching was significantly lower than that of the control group(χ^2=20.570,6.328,P<0.05).NRS score of pain after intervention was significantly lower than that before intervention(t=46.978,P<0.05),comfort score was significantly higher than that before intervention(t=56.569,P<0.05).During the intervention,drowsiness,sleepiness,hypotension,nausea,vomiting and dizziness occurred in 1 case each,all of which were improved after symptomatic support treatment and intensive observation.The control time of pruritus was(23.1±1.6)min,and the recurrence case of pruritus within 24 hours was 1 case.Conclusion For parturient women with pruritus after labor analgesia with opioid receptor agonist,butorphanol can effectively control pruritus,relieve patients’pain,improve the comfort level of treatment,and take effect quickly with fewer adverse reactions after treatment.
作者
郎秀伟
聂慧
徐传果
LANG Xiuwei;NIE Hui;XU Chuan'guo(Department of Anesthesiology,Taian Maternal and Child Health Hospital,Shandong,Taian 271000,China)
出处
《中国医药科学》
2020年第5期183-185,共3页
China Medicine And Pharmacy
