右美托咪定对剖宫产术后恶心呕吐的影响  

Effects of dexmedetomidine on postoperative nausea and vomiting in patients undergoing cesarean delivery

作　　者：张西龙 韩勇 栾翰林[2] 冯子铭[2] 屠伟峰[2] 贾济[2] ZHANG Xilong;HAN Yong;LUAN Hanlin;FENG Ziming;TU Weifeng;JIA Ji(Department of Anesthesiology,Maternity and Child Care Center of Huyi District,Xi′an 710300,China)

机构地区：[1]西安市鄠邑区妇幼保健院麻醉科,西安710300 [2]广州军区广州总医院麻醉科,广州510010

出　　处：《实用医学杂志》2018年第15期2583-2586,共4页The Journal of Practical Medicine

基　　金：广东省自然科学基金(编号:2017A030313810);广州市科技计划项目(编号:201707010027)

摘　　要：目的观察静脉镇痛泵中添加右美托咪定(DEX)是否可降低剖宫产术后恶心呕吐(PONV)的发生。方法纳入了115例剖宫产患者,随机分为两组,分别为对照组(Control,57例)和右美托咪定干预组(DEX,58例),两组患者术后都采用患者自控静脉镇痛(PCIA),Control组患者的镇痛配方为:舒芬太尼(SUF)2μg/kg+氟比洛芬酯(FLA)2 mg/kg+帕洛诺司琼(PAL)10μg/kg;DEX组配方为:DEX 4μg/kg+SUF 2μg/kg+FLA 2 mg/kg+PAL 10μg/kg。两组背景剂量均为2 mL/h,患者单次按压注药量为2 mL,两次按压间隔时间不短于15 min,注药速度不超过12 mL/h,镇痛泵内含药液的总体积均为120 mL。观察术后48 h内两组患者疼痛评分、PONV的严重程度、镇痛泵按压次数和泵内药液消耗量。结果与Control组相比,DEX组患者PONV的严重程度显著减轻、患者按压镇痛泵的次数和镇痛泵内药物消耗量显著减少(P<0.05),而镇痛水平未发生显著改变(P>0.05)。结论 DEX可显著缓解剖宫产手术患者的PONV,并可降低镇痛药物的消耗。Objective To observe whether dexmedetomidine(DEX)can attenuate postoperative nausea and vomiting(PONV)in patients undergoing cesarean delivery by patient-controlled intravenous analgesia(PCIA).Methods We enrolled 115 patients undergoing cesarean delivery in this trial.The cases were assigned into two groups randomly,including control group(n=57)and DEX group(n=58).The control group was managed by PCIA with sufentanyl(SUF)2μg/kg+flurbiprofen axetil(FLA)2 mg/kg+palonosetron(PAL)10μg/kg,and the DEX group with DEX 4μg/kg+SUF 2μg/kg+FLA 2 mg/kg+PAL 10μg/kg.The background infusion dose of the two group was 2 mL/h,at a dose of 2 mL at a single pressing.The interval time between two presses was at least 15 min,and maximum infusion dose was 12 mL/h.The total drug volume during PCIA was 120 mL in the two groups.48 h after the operation,the verbal rating scale(VRS)of pain,visual analog scale(VAS)of the PONV,total press times and total volume of the consumed drug were assessed.Results Compared with the control group,DEX reduced the PONV severity,decreased the press times and inhibited the drug consumption significantly(P<0.05),but the pain scores of the two groups were not significant at 6 h,12 h,24 h and 48 h after operation(P>0.05).Conclusions DEX can reduce the PONV severity in the patients undergoing cesarean delivery by PCIA,and decrease the analgesic drug consumption in the pump as well.

关 键 词：右美托咪定 剖宫产 术后恶心呕吐 临床研究 

分 类 号：R614[医药卫生—麻醉学] R719.8[医药卫生—外科学]