摘要
目的探讨静脉泵注右美托咪定用于分娩镇痛中转剖宫产术的临床麻醉效果。方法选择2017年12月至2018年7月首都医科大学附属北京妇产医院分娩镇痛中转剖宫产术的产妇80例,随机分为试验组(D组,40例)和对照组(C组,40例)。胎儿娩出断脐后,D组给予0.6μg/kg的右美托咪定静脉泵入,时间设定为10 min,C组给予相同剂量的生理盐水。记录给药前(T0)、给药后15 min(T1)及探查清理腹腔(T2)时产妇的MAP、HR;记录术中恶心呕吐、寒战、牵拉反应和呼吸抑制的发生率以及产妇麻醉满意度评分。结果因有产妇硬膜外麻醉失败被剔除,D组纳入36例,C组纳入38例。与C组相比,D组T1时的HR明显降低[(78.5±9.7)次/min比(91.2±10.9)次/min,P<0.05],T2时的MAP[(81.8±8.2)mmHg比(87.91±10.4)mmHg,1 mmHg=0.133 k Pa]、HR[(87.2±11.5)次/min比(94.1±12.3)次/min,P<0.05]明显降低;D组术中寒战(13.9%比34.2%)、Ⅲ级牵拉反应(8.3%比26.3%)的发生率明显降低,产妇麻醉满意度评分[(8.2±1.3)分比(7.3±1.7)分]明显增加;差异有统计学意义(P<0.05)。结论分娩镇痛中转剖宫产术中静脉给予小剂量右美托咪定可改善麻醉效果,维持血流动力学稳定,减少术中不良反应发生率,增加产妇术中舒适度和满意度。
Objective To investigate the clinical anesthetic effect of intravenous injection of dexmedetomidine in labor analgesia switch to cesarean section. Methods Eighty parturients transferred to cesarean section during labor analgesia from December 2017 to July 2018 in Beijing Obstetrics and Gynecology Hospital Affiliated to Capital Medical University were selected. They were randomly divided into trial group(group D) and control group(group C). After cutting umbilical cord,group D was injected with dexmedetomidine of 0.6 μg/kg for 10 min. Group C was given the same dose of normal saline.MAP, HR were recorded at three points: before administration(T0), 10 min after drug administration(T1) and abdominal exploration(T2). The incidence of nausea and vomiting, shivering, visceral traction reaction, and respiratory depression as well as the maternal satisfaction were all recorded. Results Due to the failure of epidural anesthesia in parturients, 36 cases were enrolled in group D and 38 cases in group C. Compared with group C, HR [(78.5±9.7) times/min vs.(91.2±10.9) times/min, P <0.05] in group D decreased significantly at T1, MAP [(81.8 ± 8.2) mmHg vs.(87.9 ± 10.4) mmHg, 1 mmHg=0.133 kPa, P <0.05] and HR [(87.2±11.5) times/min vs.(94.1±12.3) times/min, P < 0.05] of T2 in group D were significantly decreased. In group D, the incidence of shivering(13.9% vs. 34.2%) and grade Ⅲ traction reaction(8.3% vs. 26.3%) was significantly decreased, and the score of anesthesia satisfaction [(8.2±1.3) points vs.(7.3±1.7) points, P < 0.05] was significantly increased.Conclusions Intravenous administration of dexmedetomidine during labor analgesia switch to cesarean section can improve the anesthetic effect, maintain hemodynamic stability, reduce the incidence of adverse reactions, and increase the degree of comfort and satisfaction of the primiparas.
作者
白云波
徐铭军
Bai Yunbo;Xu Mingjun(Department of Anesthesiology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing100026, China)
出处
《北京医学》
CAS
2019年第8期679-682,共4页
Beijing Medical Journal
基金
北京市卫生与健康科技成果和适宜技术推广项目(2018-TG-21)
关键词
右美托咪定
分娩镇痛
剖宫产术
dexmedetomidine
labor analgesia
cesarean section
