布托啡诺硬膜外预处理对剖宫产术中寒战与牵拉反应的影响  

Effects of butorphanol epidural pretreatment on shivering and traction reaction in cesarean section

作　　者：罗芳[1] 黄建平[1] 尹新武 

机构地区：[1]江西省吉安市妇幼保健院麻醉科,江西吉安343000

出　　处：《中国当代医药》2015年第36期44-46,共3页China Modern Medicine

摘　　要：目的分析布托啡诺硬膜外预处理对剖宫产术中寒战与牵拉反应的影响。方法选取2014年6~12月本院104例健康足月单胎妊娠硬膜外麻醉下行剖宫产术的产妇,随机分为观察组和对照组,每组52例。两组均采用0.75%罗哌卡因进行硬膜外麻醉,麻醉生效后,观察组硬膜外注入布托啡诺1 mg,对照组硬膜外注入生理盐水2 ml。观察记录两组产妇术前及麻醉后15 min的MAP、HR、SpO_2,术中寒战例数与分级、清洗腹腔时牵拉反应,新生儿Apgar评分等。结果观察组术中寒战发生率及强度明显低于对照组（P〈0.05）,术中牵拉反应发生率及分级显著低于对照组（P〈0.05）,两组间各时点的MAP、HR、SpO_2及新生儿Apgar评分比较差异无统计学意义（P〉0.05）。结论布托啡诺硬膜外预处理能安全有效地预防和减轻剖宫产术中寒战与牵拉反应。Objective To analyze the effects of butorphanol epidural pretreatment on shivering and traction reaction in cesarean section.Methods 104 healthy,full-term,and single-fetus pregnant women who received cesarean section under epidural anesthesia in our hospital from June to December 2014 were selected and randomly divided into the observation group and the control group,with 52 cases in each group.Patients in both groups were anesthetized by 0.75% ropivacaine,and after anesthesia onset,patients in the observation group were epidurally injected by 1 mg butorphanol,while patients in the control group were epidurally injected by 2 ml normal saline.The MAP,HR,and Sp O2 of patients before operation and at 15 min after anesthesia,numbers and grades of shivering during operation,and traction reaction when washing the abdominal cavity,as well as the Apgar scores of newborns were observed and recorded.Results The incidence and intensity of shivering of patients in the observation group were significantly lower than that of the control group respectively（P0.05）.The incidence and grades of traction reaction during operation was significantly lower in the observation group than that in the control group respectively（P 0.05）.The MAP,HR,and Sp O2 at each time point,and Apgar scores of newborns showed no significant difference between two groups（P 0.05）.Conclusion Butorphanol epidural pretreatment can prevent and reduce the incidence of shivering and traction reaction in cesarean section with favorable safety and effectiveness.

关 键 词：布托啡诺 硬膜外 剖宫产术 寒战 牵拉反应 

分 类 号：R614.42[医药卫生—麻醉学]