右美托咪定不同时机给药对腰-硬联合麻醉后剖宫产产妇寒战反应的影响

发布时间：2018-05-26 09:13

本文选题：右美托咪定 + 剖宫产　；参考：《临床麻醉学杂志》2017年09期

【摘要】：目的比较右美托咪定不同时机给药对腰-硬联合麻醉后剖宫产产妇寒战反应的影响。方法腰-硬联合麻醉下行剖宫产产妇120例,随机分为三组,每组40例。A组与B组分别在麻醉开始前15min、胎儿娩出即刻静脉泵注右美托咪定0.4μg/kg(15 min);C组为对照组,静脉泵注等容量生理盐水。记录产妇寒战发生时间及等级,产妇Ramsay镇静程度评分以及恶心、呕吐、牵拉反应等不良反应发生情况。结果至术毕30 min,A组发现寒战2例(5.0%)、牵拉反应2例(5.0%),B组发现寒战8例(20.0%)、牵拉反应3例(7.5%),C组发现寒战19例(47.5%)、牵拉反应10例(25.0%)。与C组比较,A、B两组产妇寒战发生率明显降低,寒战程度明显减轻(P0.05),牵拉反应明显减少(P0.05)。与B组比较,A组产妇寒战发生率更低(P0.05),寒战程度也更低(P0.05);牵拉反应发生率差异无统计学意义。结论腰-硬联合麻醉前给予右美托咪定预防剖宫产产妇寒战的效果优于胎儿娩出后给药。
[Abstract]:Objective to compare the effects of dexmetomidine on shivering response of cesarean section women after combined spinal-epidural anesthesia. Methods 120 cases of cesarean section under combined spinal-epidural anesthesia were randomly divided into three groups: group A (n = 40) and group B (n = 15). Intravenous infusion of normal saline of equal volume. The time and grade of shivering, the score of Ramsay sedation and the adverse reactions such as nausea, vomiting and traction reaction were recorded. Results by 30 minutes after operation, 2 cases of shivering were found in group A, 2 cases of traction reaction were found in group B, 8 cases of shivering were found in group B, 3 cases of traction reaction were found in group C (7. 5%), 19 cases of shivering were found in group C, and 10 cases of tractive reaction were 25. 0%. Compared with group C, the incidence of shivering was significantly decreased, the degree of shivering was significantly reduced, and the traction response was significantly reduced in group A and B, respectively. Compared with group B, the incidence of shivering was lower and the degree of shivering was lower in group A than in group B, but there was no significant difference in the incidence of traction reaction. Conclusion the effect of dexmetomidine before combined spinal-epidural anesthesia on the prevention of shivering in cesarean section is better than that after fetal delivery.
【作者单位】：南京医科大学附属江苏盛泽医院麻醉科;
【分类号】：R614

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