小剂量右美托咪定与丙泊酚预防卡前列素氨丁三醇诱发剖宫产术患者不良反应的效果对比  

The effects of dexmedetomidine and propofol in prevention adverse reaction of carboprost tromethamine in the cesarean section surgery

作　　者：李海英[1] 王燕[1] 刘海[1] 

机构地区：[1]陕西省延安市人民医院麻醉科,陕西延安716000

出　　处：《临床和实验医学杂志》2015年第13期1130-1133,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的 探讨小剂量右美托咪定与丙泊酚预防剖宫产术中卡前列素氨丁三醇诱发不良反应的效果。方法选取2014年4~10月拟行子宫下段剖宫产术产妇120例,ASA分级Ⅰ级和Ⅱ级。按照随机数字表法分为观察组1、观察组2和对照组各40例。三组均在连续硬膜外麻醉下手术,胎儿娩出后,子宫肌层注射卡前列素氨丁三醇250μg。观察组1和观察组2分别于注射卡前列素氨丁三醇前1 min泵注右美托咪定0.1μg/kg,10 min后以0.4μg·kg-1·h-1持续静脉泵注或泵注丙泊酚1 mg·kg-1·min-1,1min后改3 mg·kg-1·h-1持续静脉泵注至术毕。对照组以等容量生理盐水替代。记录三组的手术时间、术中出血量、尿量及输入量等手术情况;胸闷、面色潮红、恶心、呕吐及心血管事件等卡前列素氨丁三醇不良反应;记录手术结束时及术后2 h三组的警觉/镇静（OAA/S）评分及术后泌乳始动时间。结果1三组产妇的年龄、体重、孕周等一般情况和手术时间、术中出血量、输入量等手术情况比较差异均无统计学意义（P〉0.05）。2观察组1和观察组2的胸闷、面色潮红、恶心、呕吐、高血压、心动过速等不良反应发生率均明显低于对照组,差异具有统计学意义（均P〈0.05）,而两观察组间比较各项指标差异无统计学意义（P〉0.05）。3三组的OAA/S评分及术后泌乳始动时间比较差异无统计学意义（P〉0.05）。结论 小剂量右美托咪定和丙泊酚均有助于预防剖宫产中因卡前列素氨丁三醇引起的不良反应,且不影响产妇麻醉苏醒和泌乳。Objective To explore the effects of dexmedetomidine and propofol in prevention adverse reaction of carboprost tromethamine in the cesarean section surgery. Methods 120 cases of lower uterine segment cesarean section patients with ASA class Ⅰ and Ⅱ from April 2014 to October 2014 were selected and divided into observation group 1,observation group 2 and control group（ n = 40） according to the random number table method. The three groups were given continuous epidural anesthesia surgery after fetal childbirth,given carboprost tromethamine 250 μg.The observation group 1 was given dexmedetomidine 0. 1 μg / kg before using carboprost tromethamine. These patients were given 0. 4 μg·kg- 1·h- 1to 10 min after surgery finishing. The observation group 2 was given propofol 1 mg·kg- 1·min- 1,after 1 min given 3 mg·kg- 1·h- 1. The control group was given saline water. The operation conditions such as operation time,intraoperative blood loss volume,urine volume and input volume of the three groups,the carboprost tromethamine adverse reactions,such as chest distress,flushed face,nausea,vomiting and cardiovascular events were recorded. The OAA / S score at the end of the operation and postoperative 2 h of the three groups and postoperative lactation pick up time were recorded. Results 1The age,weight,gestational weeks and operation time,intraoperative blood loss volume,urine volume and input volume of the three groups of the patients has no statistical significant difference（ P〉0. 05）. 2The carboprost tromethamine adverse reactions such as chest distress,flushed face,nausea,vomiting and cardiovascular events of the observation group 1 and observation group 2 were significantly lower than the control group,the difference had statistically significant（ P〈0. 05）,the difference of the two observation groups had no statistical significance（ P〉0. 05）. 3The OAA / S score and postoperative lactation pick up time of the three groups had no statistically significant difference（ P〉0. 05）. Conclusion

关 键 词：剖宫产 卡前列素 不良反应 右美托咪定 丙泊酚 

分 类 号：R614[医药卫生—麻醉学]