右美托咪啶与杜氟合剂预防剖宫产术中卡前列素氨丁三醇不良反应效果的比较  

The effects of Dexmedetomidine and DF mixture in prevention adverse reaction of carboprost in patients undergoing cesarean section

作　　者：黄伟[1] 李平[1] 罗林丽[1] 林远贵[1] 黄蔚[1] 

机构地区：[1]四川大学华西第二医院麻醉科.出生缺陷与相关妇儿疾病教育部重点实验室,四川成都610041

出　　处：《西部医学》2016年第10期1374-1377,共4页Medical Journal of West China

基　　金：科技部新药重大专项课题(2015ZX09102010)

摘　　要：目的比较右美托咪定和杜氟合剂预防剖宫产术中卡前列素氨丁三醇不良反应的效果。方法拟在腰硬联合麻醉下行择期子宫下段剖宫产术患者60例,随机分为右美托咪定组(D组)和杜氟合剂组(DF组)各30例。于胎儿娩出后、使用卡前列素氨丁三醇前2min,D组泵注右美托咪定0.5μg/kg,DF组静注半剂杜氟合剂(哌替啶50mg+氟哌啶2.5mg)。记录卡前列素氨丁三醇给药后恶心、呕吐、胸闷、面色潮红和心血管不良事件的发生情况,记录卡前列素氨丁三醇给药前(T_0)、给药后10min(T_1)和手术结束时(T_2)产妇的OAA/S评分。结果两组恶心、呕吐、胸闷、面部潮红的发生率无显著差异(P>0.05),D组高血压的发生率显著高于DP组(P<0.05),心动过速发生率显著低于DP组(P<0.05)。DP组T_1、T_2时OAA/S评分与T_0时比显著降低(P<0.05);D组OAA/S评分T_1时显著低于T_0时(P<0.05),T2与T0时差异无统计学意义(P>0.05)。两组患者在T_0、T_1时的OAA/S评分差异无统计学意义(P>0.05),T_2时D组显著高于DP组(P<0.05)。结论孕妇在剖宫产术中,卡前列素氨丁三醇给药前给予小剂量右美托咪定(0.5μg/kg)和半剂杜氟合剂均有助于预防其诱发的胃肠道和心血管不良反应的发生。Objective To compare the effect of Dexmedetomidine and DF mixture（pethidine and droperidol mix- ture） and prevent adverse reactions caused by carboprost during cesarean section. Methods 60 parturients scheduled for lower-uterine cesarean section under lumbar epidural anesthesia were randomly divided into a Dexmedetomidine group （D group） and DF mixture group （DF group）, which received 0. 5 μg/kg Dexmedetomidine or DF mixture （pethidine 50 mg ＋droperidol 2.5 mg） respectively after delivery and 2 min before administration of Carboprost. Nausea, vomiting, dyspnea, facial flushing, and cardiovascular adverse events after administration of Carboprost, and OAA/S score of the mother before Carboprost administration （T0）, 10min after Carboprost administration （T1）, and right after surgery （T2） were recorded. Results Incidence of nausea, vomiting, dyspnea, and facial flushing showed no significant difference between the two groups （P〉0.05）. Incidence of hypertension in the D group was significantly higher than that in DP group （P〈0.05）. Incidence of tachycardia in DP group was significantly lower that in D group （P〈0.05）. OAA/S score of the patients at T0 and T1 showed no significant difference between the two groups. But at T2, OAA/S score in D group was significantly higher than that in DP group （P〈0.05）. Conclusion Pre-administration of low-dose Dexmedetomidine （0.5 μg/kg） or half-dose DF mixture before Carboprost administration during cesarean section can significantly reduce the incidence of adverse reactions of the gastrointestinal and cardiovascular system evoked by Carboprost.

关 键 词：右美托咪定 杜氟合剂 卡前列素氨丁三醇 剖宫产 不良发应 

分 类 号：R614.4[医药卫生—麻醉学]