氯普鲁卡因注射液联合吗啡注射液硬膜外麻醉对剖宫产术后镇痛的临床研究

发布时间：2018-05-27 05:38

  本文选题：氯普鲁卡因 + 吗啡　； 参考：《中国临床药理学杂志》2017年02期

【摘要】：目的观察氯普鲁卡因联合吗啡硬膜外麻醉对剖宫产术后镇痛效果及其对炎症因子的影响。方法将150例进行剖宫产的产妇随机分为A组50例、B组50例及C组50例。3组患者均进行腰硬联合麻醉,并于腰麻后55 min注射吗啡2 mg。A组于注射吗啡前10 min静脉注射3%氯普鲁卡因5 mL,B组于注射吗啡后10 min静脉注射3%氯普鲁卡因5 mL,C组于注射吗啡前10 min静脉注射0.9%NaCl 5 mL。比较3组产妇的体征情况、手术时间、麻醉药物用量、围术期炎症因子、术后疼痛视觉模拟量表(VAS)评分变化,以及药物不良反应的发生情况。结果术后4 h,A、B、C组的疼痛视觉模拟评分分别为(3.17±0.26),(1.95±0.28),(2.04±0.31)分,差异均有统计学意义(P0.05)。A、B、C组的手术时间分别为(48.26±7.91),(48.85±7.64),(49.13±7.52)min,差异均无统计学意义(P0.05)。A、B、C组的舒芬太尼用量分别为(44.26±8.15),(31.06±7.21),(35.84±9.13)μg,B组与A、C组比较差异均有统计学意义(P0.05)。术后12 h,A、B、C组的白细胞介素-2(IL-2)分别为(1.57±0.58),(2.31±0.65),(2.07±0.46)pg·L~(-1);IL-6分别为(143.29±15.81),(120.26±18.91),(133.08±16.51)pg·L~(-1);IL-10分别为(106.24±8.63),(78.20±7.64),(83.96±7.85)pg·mL~(-1);肿瘤坏死因子-α分别为(171.80±18.36),(97.30±26.13),(149.21±24.41)pg·L~(-1),差异均有统计学意义(P0.05)。3组产妇的药物不良反应均为皮肤瘙痒和呕吐,且A、B、C组产妇的药物不良反应发生率分别为36.00%,30.00%,34.00%,差异无统计学意义(P0.05)。结论硬膜外依次注射吗啡、氯普鲁卡因,能够起到良好的镇痛效果,降低产妇舒芬太尼使用量,并能够维持炎性因子平衡,减轻术后炎症反应。
[Abstract]:Objective to observe the analgesic effect of chloroprocaine combined with morphine epidural anesthesia on postoperative analgesia of cesarean section and its effect on inflammatory factors. Methods 150 cases of parturient undergoing cesarean section were randomly divided into group A (n = 50) and group C (n = 50) under combined spinal-epidural anesthesia. The rats in group B were injected with 3% chloroprocaine 5 mL / L 10 min before morphine injection, and group C was injected with 3% chloroprocaine 5 mL / L 10 min after morphine injection. 0.9%NaCl 5 mL was injected 10 min before morphine injection in group C (n = 10). The changes of physical signs, operation time, dosage of anesthetic drugs, perioperative inflammatory factors, postoperative pain visual analogue scale (VAS) scores and adverse drug reactions were compared among the three groups. Results the visual analogue scores of pain in group C were 3.17 卤0.26, 1.95 卤0.28 and 2.04 卤0.31, respectively. The time of operation was 48.26 卤7.91, 48.85 卤7.64, 49.13 卤7.52 min, respectively. There was no significant difference in the dosage of sufentanil between the two groups (44.26 卤8.15, 31.06 卤7.21, 35.84 卤9.13) 渭 g / min, respectively. 鏈�鍚�12 h,A,B,C缁勭殑鐧界粏鑳炰粙绱，

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