硬膜外右美托咪定自控镇痛对剖宫产产妇术后疼痛及焦虑状况的影响

发布时间：2019-02-16 09:28

【摘要】：目的探讨右美托咪定复合左布比卡因用于硬膜外自控镇痛的效果及对产妇焦虑状况的影响。方法择期剖宫产术产妇40例,采用腰硬联合麻醉,术后硬膜外自控镇痛,随机分为两组,每组20例,其中对照组(C组):泵内0.1%左布比卡因150 m L;右美托咪定组(D组):泵内0.1%左布比卡因150 m L+右美托咪定2μg/kg。分别观察患者开启自控镇痛泵后6、12、24、48 h各时点静息状态VAS评分、Ramesay镇静评分、不良反应以及术前、术后1、2 d的焦虑自评量表(SAS)评分。结果 12、24、48 h 3个时间点C组VAS评分明显高于D组(P0.05)。D组镇痛泵药液总用量,总按压次数和有效按压次数都明显少于C组;D组患者术后镇痛总体满意度为89%,明显优于C组。两组产妇术后1、2 d SAS评分与术前比较差异有统计学意义(P0.05)。D组术后1、2 d SAS评分与C组比较差异有统计学意义(P0.05)。术后各个时间点Rasmay镇静评分、尿潴留和皮肤瘙痒等差异无统计学意义(P0.05),D组术后恶心呕吐发生率比C组明显减少(P0.05)。结论 2μg/kg右美托咪定用于剖宫产术后硬膜外镇痛时,明显增强了术后镇痛效果,并能减轻孕妇术后焦虑情绪,减少了总用药量和不良反应发生率。
[Abstract]:Objective to investigate the effect of dexmetomidine combined with levobupivacaine on patient-controlled epidural analgesia and the anxiety of parturient. Methods Forty parturients undergoing elective cesarean section were randomly divided into two groups: control group (group C): 0.1% levobupivacaine 150ml in pump; Group D: 0.1% levobupivacaine 150 mL dexmetomidine 2 渭 g / kg. The VAS scores, Ramesay sedation scores, adverse reactions and (SAS) scores of anxiety scale at each time point of 612 minutes and 24 minutes 48 hours after the operation of the PCAP were observed, as well as the preoperative and postoperative (SAS) scores at 1 and 2 days after operation. Results the VAS score of group C was significantly higher than that of group D (P0.05). The total dosage of analgesic pump, the times of total pressing and the times of effective pressing in group C were significantly lower than those in group C (P0.05). The total satisfaction of postoperative analgesia in group D was 89, which was significantly better than that in group C. There was significant difference in SAS score between the two groups on the 1st and 2nd day after operation (P0.05). The SAS score of the). D group was significantly higher than that of the C group (P0.05). There was no significant difference in Rasmay sedation score, urinary retention and skin pruritus at different time points after operation (P0.05). The incidence of nausea and vomiting in), D group was significantly lower than that in C group (P0.05). Conclusion 2 渭 g/kg dexmetidine for epidural analgesia after cesarean section can significantly enhance the postoperative analgesia effect, reduce postoperative anxiety, reduce the total dosage of drugs and the incidence of adverse reactions.
【作者单位】：广东省惠州市第二妇幼保健院麻醉科;
【分类号】：R614

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