右美托咪定对妊高症患者剖宫产术后舒芬太尼硬膜外自控镇痛的影响  

Influence of dexmedetomidine on sufentanil patient-controlled epidural analgesia after cesarean section in pregnancy-induced hypertension patients

作　　者：肖圣华[1] 谭素云[1] 王智钧[1] 陈怀佳 

机构地区：[1]广东医学院附属东莞厚街医院麻醉科,523945

出　　处：《中国实用医药》2015年第23期7-9,共3页China Practical Medicine

摘　　要：目的探讨右美托咪定对妊娠高血压综合征(妊高症)患者剖宫产术后舒芬太尼硬膜外自控镇痛的影响。方法 40例择期行剖宫产术妊高症患者,随机分为研究组和对照组,每组20例。两组采用腰硬联合麻醉,术后镇痛方式采用舒芬太尼复合罗哌卡因硬膜外自控镇痛,同时研究组静脉泵注右美托咪定0.3μg/(kg·h),而对照组用生理盐水代替右美托咪定。记录术前(T0)、术毕(T1)、术后12 h(T2)、24 h(T3)、48 h(T4)的平均动脉压(MAP)和心率(HR),记录T2、T3、T4时的Ramsay镇静(RSS)评分、视觉模拟镇痛(VAS)评分,术后48 h内舒芬太尼累计消耗量和恶心、呕吐、皮肤瘙痒、寒战等不良反应的发生情况,降压药的使用情况及患者满意度。结果 T2、T3、T4时,对照组的MAP、HR高于研究组,差异有统计学意义(P<0.05);研究组的VAS评分比对照组低(P<0.05),研究组的RSS评分比对照组高(P<0.05);但是两组均无RSS评分>4分的患者,研究组的舒芬太尼累计消耗量低于对照组(P<0.05)。研究组患者的满意度高于对照组,不良反应发生率低于对照组(P<0.05)。结论术后静脉泵注右美托咪定0.3μg/(kg·h),增强了妊高症患者剖宫产术后舒芬太尼硬膜外自控镇痛效果,有助于维护心血管稳定,减少不良反应,提高患者满意度。Objective To investigate influence of dexmedetomidine on sufentanil patient-controlled epidural analgesia after cesarean section in pregnancy-induced hypertension patients. Methods A total of 40 pregnancy-induced hypertension patients receiving cesarean section were randomly divided into research group and control group, with 20 cases in each group. Both groups received combined spinal epidural anesthesia, and sufentanil combined with ropivacaine in patient-controlled epidural analgesia. The research group received additional 0.3 μg/（kg·h） dexmedetomidine through intravenous pumping, while the control group received normal saline. Mean arterial pressure（MAP） and heart rate（HR） were recorded before operation（T0）, after operation（T1）, 12 h after operation T2, T3, and T4. Ramsay sedation score（RSS） and visual analogue scale（VAS） score were recorded in T2, T3, and T4. Records were also made on cumulative sufentanil consumption within 48 h after operation, adverse reactions as nausea, emesis, pruritus, shivering, hypotensive drugs, and patients＇ satisfaction degree. Results The control group had higher MAP and HR than the research group at T2, T3, and T4, and their differences had statistical significance（P〈0.05）. The research group had lower VAS score than the control group（P〈0.05）, and it had higher RSS score than the control group（P〈0.05）. However, both groups had no case with RSS score 4 points. The research group had less cumulative sufentanil consumption than the control group（P〈0.05）. The research group also had higher satisfaction degree and lower incidence of adverse reactions than the control group（P〈0.05）. Conclusion Implement of 0.3 μg/（kg·h） dexmedetomidine through intravenous pumping after operation can improve sufentanil patient-controlled epidural analgesia after cesarean section in pregnancy-induced hypertension patients. This method is helpful for maintain cardiovascular stability, reduce adverse reactions, and improve patients＇ st

关 键 词：右美托咪定 妊娠高血压综合征 舒芬太尼 硬膜外自控镇痛 

分 类 号：R614[医药卫生—麻醉学]