摘要
目的:评估在硬膜外麻醉中使用右美托咪定对剖宫产的镇痛及麻醉效果。方法:2019年1月-2020年1月收治行剖宫产手术的产妇80例,随机分为两组,各40例。观察组给予注射12 mL含有2 mg吗啡及0.5μg/kg右美托咪定的0.75%罗哌卡因溶液,进行硬膜外麻醉;对照组不加入右美托咪定。观察组术后给予含有200μg右美托咪定及2 mg吗啡的0.2%罗哌卡因溶液,按照2 mL/h剂量进行术后镇痛;而对照组在观察组基础上减掉右美托咪定,进行同样的术后镇痛。比较两组临床效果。结果:观察组麻醉起效时间、完全运动阻滞时间及改良Ramsay镇静评分均明显低于对照组,差异有统计学意义(P<0.05)。观察组术后恶心呕吐发生率高于对照组,差异有统计学意义(P<0.05);两组其他不良反应发生率比较,差异无统计学意义(P>0.05)。两组新生儿出生后1 min和5 min的Apgar评分比较,差异无统计学意义(P>0.05)。结论:右美托咪定在剖宫产手术中能够起到较好的镇静作用,起效时间快,麻醉时间长,对吗啡相关不良反应及术后镇痛无明显影响。
Objective:To investigate the analgesic and anesthetic effect of dexmedetomidine in epidural anesthesia for cesarean section.Methods:From January 2019 to January 2020,80 pregnant women undergoing cesarean section were selected and randomly divided into two groups with 40 cases in each group.The observation group was given 12 mL of 0.75%ropivacaine solution containing 2 mg morphine and 0.5μg/kg dexmedetomidine for epidural anesthesia.The control group was not given dexmedetomidine.After operation,the observation group was given 0.2%ropivacaine solution containing 200μg dexmedetomidine and 2 mg morphine for postoperative analgesia according to the dosage of 2 mL/h.The control group was given the same postoperative analgesia,but the dexmedetomidine was reduced on the basis of the observation group.We compared the clinical effects of the two groups.Results:In the observation group,the onset time of anesthesia,complete motor block time and modified Ramsay Sedation score were significantly lower than those in the control group,the difference was statistically significant(P<0.05).In the observation group,the incidence of postoperative nausea and vomiting was higher than that in the control group,the difference was statistically significant(P<0.05).There was no significant difference in the incidence of other adverse reactions between the two groups(P>0.05).There was no significant difference in Apgar score between the two groups at 1 minute and 5 minutes after birth(P>0.05).Conclusion:Dexmedetomidine can play a better sedative role in cesarean section,the onset time is fast and the anesthesia time is long,there was no significant effect on morphine related adverse reactions and postoperative analgesia.
作者
秦力弘
罗钧升
Qin Lihong;Luo Junsheng(Surgery Anesthesia Department,the Maternal and Child Health Hospital of Fuling District,Chongqing City,Chongqing 408000)
出处
《中国社区医师》
2021年第17期47-48,共2页
Chinese Community Doctors
关键词
右美托咪定
硬膜外麻醉
剖宫产
镇痛
麻醉
Dexmedetomidine
Epidural anesthesia
Cesarean section
Analgesia
Anesthesia
