摘要
目的:探讨0.1 mg/kg纳布啡对腰-硬联合麻醉剖宫产产妇血流动力学、术后疼痛及寒战的影响。方法:选择2021年4月—2023年4月泉州市第一医院接收的拟行剖宫产产妇100例作为研究对象,术中采取腰-硬联合麻醉,采用随机数字表法分为观察组和对照组,各50例。观察组在胎儿娩出后夹闭脐带即刻静注0.1 mg/kg纳布啡,对照组注入等容量0.9%氯化钠溶液。比较两组麻醉前、用药即刻、用药30 min及用药6 h的血流动力学指标,比较两组Ramsay镇静评分、视觉模拟评分法(VAS)评分,比较两组寒战发生情况及用药后不良反应发生情况。结果:麻醉前、用药即刻,两组HR、MAP、SpO2比较差异均无统计学意义(P>0.05);与麻醉前相比,用药即刻两组HR、MAP、SpO2均明显降低(P<0.05);与用药即刻比较,用药30 min、6 h时观察组HR、MAP差异均无统计学意义(P>0.05),SpO2均明显升高(P<0.05);对照组HR、MAP均明显升高(P<0.05),SpO2比较差异均无统计学意义(P>0.05);用药30 min、6 h时观察组HR、MAP均低于对照组,SpO2均高于对照组(P<0.05)。观察组Ramsay镇静评分情况和VAS评分情况均优于对照组(P<0.05)。观察组寒战发生情况优于对照组(P<0.05)。观察组用药后不良反应发生率为8.00%,与对照组14.00%比较,差异无统计学意义(P>0.05)。结论:腰-硬联合麻醉剖宫产胎儿娩出后即刻静注0.1 mg/kg纳布啡维持产后稳定的血流动力学,并可进一步提高镇静、镇痛效果,有效预防和减轻术后寒战,而且用药不良反应少,安全性高。
Objective:To investigate the effects of 0.1 mg/kg Nalbuphine on hemodynamics,postoperative pain and chills of parturiants undergoing cesarean section under combined lumbo-epidural anesthesia.Method:A total of 100 pregnant women who planned to undergo cesarean section in Quanzhou First Hospital from April 2021 to April 2023 were selected as the research objects,combined lumbo-epidural anesthesia was adopted during the operation,random number table method was used to divide them into observation group and control group,50 cases in each group.The observation group was injected with 0.1 mg/kg Nalbuphine immediately after delivery after the umbilical cord was clip-on,the control group was injected with 0.9%Sodium Chloride Solution of equal volume.The hemodynamic indexes of the two groups were compared before anesthesia,immediately after medication,30 min and 6 h,Ramsay sedation score and visual analog scale(VAS)score of the two groups were compared,and the occurrence of chills and adverse reactions after medication were compared between the two groups.Result:Before anesthesia and immediately after medication,there were no significant differences in HR,MAP and SpO2 between the two groups(P>0.05);compared with before anesthesia,HR,MAP and SpO2 in both groups were significantly decreased immediately after treatment(P<0.05);compared with the immediate treatment,HR and MAP of the observation group had no statistical significance at 30 min and 6 h after treatment(P>0.05),SpO2 were significantly increased(P<0.05);in control group,HR and MAP were significantly increased(P<0.05),while SpO2 had no statistical significance(P>0.05);HR and MAP in observation group were lower than those of the control group,SpO2 were higher than those of control group at 30 min and 6 h(P<0.05).Ramsay sedation score and VAS score in the observation group were better than those in the control group(P<0.05).The incidence of chills in the observation group was better than that in the control group(P<0.05).The incidence of adverse reactions was 8.00%in the observation group,which had no statistical significance compared with 14.00%in the control group(P>0.05).Conclusion:Intravenous injection of 0.1 mg/kg Nalbuphine immediately after delivery of the fetus in cesarean section under combined lumbar and epidural anesthesia can maintain stable postpartum hemodynamics,further improve sedation and analgesia,effectively prevent and alleviate postoperative chills,and have less adverse drug reactions and high safety.
作者
林小玲
杨丽萍
陈强
LIN Xiaoling;YANG Liping;CHEN Qiang(Department of Anesthesiology,Quanzhou First Hospital,Quanzhou 362002,China;不详)
出处
《中国医学创新》
CAS
2024年第8期64-68,共5页
Medical Innovation of China
关键词
剖宫产
腰-硬联合麻醉
纳布啡
血流动力学
疼痛
寒战
Cesarean section
Lumbo-epidural anesthesia
Nalbuphine
Hemodynamics
Pain Shiver
