纳布啡复合恩丹司琼预防剖宫产术蛛网膜下腔麻醉后瘙痒  

作　　者：陈岱莉[1] 齐晓非[1] 庄仁坤[1] 曹君[1] 黄晓雷[1] 李元涛[1] 

机构地区：[1]南方医科大学附属深圳妇幼保健院麻醉科,518028

出　　处：《浙江临床医学》2017年第10期1935-1936,共2页Zhejiang Clinical Medical Journal

摘　　要：目的观察比较纳布啡、恩丹司琼、纳布啡复合恩丹司琼预防剖宫产术蛛网膜下腔麻醉后瘙痒的效果。方法选择择期实施剖宫产术的患者160例，年龄23-33岁，ASAI或II级，随机分成4纽，纳布啡纽（N纽）、恩丹司琼组（O纽）、纳布啡复合恩丹司琼组（NO纽）和生理盐水组（P组），每组各40例。麻醉穿刺成功后，蛛网膜下腔给予0．5％罗哌卡因2．2ml含吗啡0．15mg。胎儿娩出后，N组静脉给予纳布啡3mg，0组静脉给予恩丹司琼4mg，NO组静脉给予纳布啡3mg和恩丹司琼4mg，P组给予相同容量的生理盐水。给药后2h、3h、4h和8h进行瘙痒评分，N时记录疼痛程度，镇静程度，寒战、恶心呕吐等发生情况。结果给药后3h、4hTL8h，N组、0组、NO组瘙痒评分明显小于P组（P均〈0．05），N组与NO组比较，o组与NO组比较，N组与O纽比较，瘙痒评分差异无统计学意义（P均〉0．05）。N组、NO组寒战发生率较P组低，O组、NO组恶心呕吐发生率较P组低（p均〈0．05）。结论纳布啡复合恩丹司琼能有效预防剖宫产术蛛网膜下腔麻醉后瘙痒，且能减少寒战、恶心呕吐等不良反应的发生。Objective To evaluate the efficacy of nalbuphine, ondansetron and nalbuphine plus ondansetron in prevention of pruritus after spinal anaesthesia in cesarean section. Methods 160 parturients （ 23-33 years old, ASA I-II ） scheduled for cesarean section were randomized into 4 groups with 40 in each group： N group, O group, NO group and the placebo group. After cerebrospinal fluid was obtained, 0.5% ropivacaine 2.2ml and morphine 0.15mg was administered through spinal needle. After baby was delivered, N group was treated with nalbuphine （ 3rag ） , O group was treated with ondansetron （ 4mg ） , NO group was treated with nalbuphine （ 3rag ） plus ondansetron （ 4mg ） intravenous infusion or P group was treated with saline. Then pruritus scores were recorded at 2h, 3h, 4h and 8h after the drugs was given. Visual analogue Pain scale, sedation scale and side effects such as shivering, nausea and vomiting were also recorded. Results Pruritus scores in N group, O group and NO group were significantly lower than P group at 3h, 4h and 8h after the drug was given （ P〈0.05 ） . There was no significant different between N and NO group, O and NO group, N and NO group in pruritus scores. The incidence of shivering in N group or NO group was significantly lower than P group, the incidence of nausea and vomiting in O group or NO group was significantly lower than P group. Conclusion Prophylactic nalbuphine （ 3mg ） and ondansetron （ 4mg ） reduce pruritus after spinal anaesthesia in cesarean section, and the side effects such as shivering, nausea and vomiting are also reduced.

关 键 词：瘙痒 纳布啡 恩丹司琼 蛛网膜下腔麻醉 剖宫产术 

分 类 号：R743.35[医药卫生—神经病学与精神病学]