摘要
目的研究右美托咪定(dexmedetomidine,Dex)对剖宫产产妇术后恢复质量及其相关影响因素的分析。方法择期腰硬联合麻醉下行剖宫产术的产妇100例,按随机数字表法分为Dex组(D组)和对照组(C组),每组50例。在胎儿娩出断脐后,D组予Dex 0.5μg/kg的负荷剂量泵注10 min,随后以0.5μg·kg−1·h−1泵注至手术结束。C组按同样方法予等体积生理盐水。术后采用患者自控静脉镇痛(patient controlled intravenous analgesia,PCIA)(配置总容量100 ml),D组Dex 2μg/kg+舒芬太尼1.5μg/kg,C组1.5μg/kg舒芬太尼。记录产妇术前1 d,术后1、3、5 d术后恢复质量调查问卷(Quality of Recovery 40 Ques⁃tionnaire,QoR⁃40)得分,根据术后3 d QoR⁃40得分分为高分组(>170分,76例)和低分组(≤170分,18例)。收集产妇年龄、教育年限、手术时间、术中出血量,记录泵药前(T1)、泵药后5 min(T2)、泵药后10 min(T3)、清洗探查腹腔(T4)、术毕(T5)时产妇内脏痛牵拉反应评分,记录术后2、4、6、12、24 h产妇静息、运动VAS评分及Ramsay镇静评分,记录术前1 d及术后1、3 d疲劳量表⁃14(Fatigue Scale⁃14,FS⁃14)评分、医院焦虑抑郁量表(Hospital Anxiety and Depression Scale,HADS)评分、主观睡眠质量评分、是否丈夫陪产等资料,记录术后48 h镇痛补救率及不良反应发生情况。对相关因素进行单因素分析和多因素Logistic回归分析。结果两组产妇术后1、3 d QoR⁃40得分较术前1 d下降(P<0.05),术后3 d QoR⁃40得分D组高于C组(P<0.05)。两组产妇术后48 h镇痛补救率及不良反应发生率差异无统计学意义(P>0.05)。单因素分析结果显示,高分组与低分组相比,两组产妇术前1 d HADS焦虑评分、FS⁃14评分及术后1、3 d HADS焦虑评分、HADS抑郁评分、FS⁃14评分,术后4、12 h运动VAS评分,术后24 h静息VAS评分等,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,术前HADS焦虑评分是影响患者术后恢复的独�
Objective To study the effect of dexmedetomidine(Dex)on the recovery quality after cesarean section and its re⁃lated factors.Methods One hundred patients undergoing cesarean section under combined spinal⁃epidural anesthesia were divided into two groups by random number table method:Dex group(group D,n=50)and control group(group C,n=50).After the delivery of the severed umbilical cord,patients in group D were firstly given a loading dose of Dex 0.5μg/kg for 10 min.Subsequently,0.5μg·kg−1·h−1 Dex was pumped until the end of operation.For the patients in group C,following the same procedure,the Dex was replaced by the same volume of normal saline.After operation,the postoperative analgesia was performed with patient controlled intravenous analgesia(PCIA)(total volume 100 ml)in both groups.The drug used in group D was Dex 2.0μg/kg+sufentanil 1.5μg/kg while the drug used in group C was 1.5μg/kg sufentanil only.Record the Quality of Recovery 40 Questionnaire(QoR⁃40)scores at 1,3,5 d after operation and 1 d before operation.According to the scores of QoR⁃40 at 3rd day after operation,the patients were divided into two groups:high score(>170,76 cases)group and low score group(≤170,18 cases).The maternal age,education years,operation time,intraoperative blood loss,visceral pain traction reaction of parturients before pumping(T1),after pumping 5 min(T2),10 min(T3),cleaning exploratory abdominal cavity(T4),at the end of operation(T5),the Visual Analogue Scale(VAS)score(quiet and turn over),Ramsay sedation score at 2,4,6,12,24 h after operation,Fatigue Scale⁃14(FS⁃14)fatigue scores at 1,3 d after operation,scores of Hospital Anxiety and De⁃pression Scale(HADS),subjective sleep quality scores and husband's accompanying delivery were collected.Record the ratio of anal⁃gesic rescue within 48 h and adverse reactions after operation.Univariate and multivariate Logistic regression analysis was used to ana⁃lyze the related factors.Results The QoR⁃40 scores of the two groups on the 1st and 3rd day af
作者
许晶晶
陈耀
田环环
刘金东
Xu Jingjing;Chen Yao;Tian Huanhuan;Liu Jindong(Department of Anesthesiology,Affiliated Hospital of Xuzhou Medical University,Xuzhou 221002,China;Department of Anesthesiology,Northern Jiangsu People's Hospital,Yangzhou 225001,China)
出处
《国际麻醉学与复苏杂志》
CAS
2020年第12期1140-1145,共6页
International Journal of Anesthesiology and Resuscitation
关键词
右美托咪定
剖宫产
术后恢复
Dexmedetomidine
Cesarean section
Postoperative recovery
