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右美托咪定复合罗哌卡因硬膜外自控镇痛在初产妇分娩中的应用效果

Application effects of Dexmedetomidine combined with Ropivacaine for patient-controlled epidural analgesia in primipara delivery
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摘要 目的:观察右美托咪定复合罗哌卡因硬膜外自控镇痛在初产妇分娩中的应用效果。方法:选取2022年1月至2023年6月于该院分娩的188例初产妇进行前瞻性研究,按照随机数字表法将其分为对照组和观察组各94例。对照组给予罗哌卡因镇痛,观察组在对照组基础上复合右美托咪定镇痛。比较两组不同时间[镇痛前(T_(0))、镇痛后10 min(T_(1))、镇痛后30 min(T_(2))、胎儿即刻娩出时(T_(3))]血流动力学指标[心率、收缩压、平均动脉压(MAP)]水平、不同时间(镇痛前、镇痛后20 min、宫口全开)分娩疼痛程度[视觉模拟评分(VAS)]评分、氧化应激指标[超氧化物歧化酶(SOD)、同型半胱氨酸(Hcy)]水平及不良反应发生率。结果:T_(1)、T_(3)时,两组心率、收缩压及MAP水平均低于T_(0)时,但观察组高于对照组,差异有统计学意义(P<0.05);T_(2)时,两组心率水平均低于T_(0)时,但组间比较,差异无统计学意义(P>0.05);两组收缩压和MAP水平均低于T_(0)时,但观察组高于对照组,差异有统计学意义(P<0.05);镇痛后20 min、宫口全开时,两组VAS评分均低于镇痛前,且观察组低于对照组,差异有统计学意义(P<0.05);分娩后1 d,两组SOD水平均低于分娩前,但观察组高于对照组,两组Hcy水平均高于分娩前,但观察组低于对照组,差异有统计学意义(P<0.05);观察组不良反应发生率为2.13%(2/94),低于对照组的9.57%(9/94),差异有统计学意义(P<0.05)。结论:右美托咪定复合罗哌卡因硬膜外自控镇痛应用于初产妇分娩,可稳定血流动力学指标水平,减轻分娩疼痛和氧化应激反应,降低不良反应发生率,效果优于单纯罗哌卡因硬膜外自控镇痛。 Objective:To observe application effects of Dexmedetomidine combined with Ropivacaine for patient-controlled epidural analgesia in primipara delivery.Methods:A prospective study was conducted on 188 primiparas who gave birth in the hospital from January 2022 to June 2023.According to the random number table method,they were divided into control group and observation group,94 cases in each group.The control group was given Ropivacaine for analgesia,while the observation group was given Dexmedetomidine for analgesia on the basis of that of the control group.The hemodynamic index levels[heart rate,systolic blood pressure and mean arterial pressure(MAP)]at different time[before analgesia(T_(0)),10 min after analgesia(T_(1)),30 min after analgesia(T_(2)),and immediate delivery of the fetus(T_(3))],the visual analogue scale(VAS)scores at different time(before analgesia,20 min after analgesia,immediate delivery of fetus),the oxidative stress index[superoxide dismutase(SOD),homocysteine(Hcy)]levels,and the incidence of adverse reactions were compared between the two groups.Results:At T_(1)and T_(3),the heart rate,systolic blood pressure and MAP levels of the two groups were lower than those at T_(0),but those in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).At T_(2),the heart rate levels of both groups were lower than at those at T_(0),but there was no statistically significant difference between the two groups(P>0.05).The systolic blood pressure and MAP levels of the two groups were lower than those at T_(0),but those in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).20 min after analgesia and when the cervix was fully opened,the VAS scores of the two groups were lower than those before analgesia,those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).1 day after delivery,the SOD level of t
作者 范瑞 FAN Rui(Department of Anesthesiology of Luohe Maternal and Child Health Hospital,Luohe Third People’s Hospital,Luohe 462001 Henan,China)
出处 《中国民康医学》 2024年第10期69-72,共4页 Medical Journal of Chinese People’s Health
关键词 右美托咪定 罗哌卡因 硬膜外自控镇痛 初产妇 血流动力学 疼痛 氧化应激 Dexmedetomidine Ropivacaine Patient-controlled epidural analgesia Primipara Hemodynamics Pain Oxidative stress
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