纳布啡预防硬膜外麻醉剖宫产术中牵拉痛的效果观察  

The effect of nalbuphine in the prevention of the traction pain during the cesarean section of epidural anesthesia

作　　者：朱雁鸿[1] 廖飞[1] 陈静宜[1] Zhu Yanhong;Liao Fei;Chen Jingyi(People’s Hospital Of Yuxi City Of Yunnan Province,Yuxi Of Yunnan Province,653100,China)

机构地区：[1]昆明医科大学第六附属医院暨玉溪市人民医院

出　　处：《首都食品与医药》2019年第22期49-50,共2页Capital Food Medicine

摘　　要：目的观察纳布啡在硬膜外麻醉下对剖宫产术中牵拉痛的预防作用。方法选取80例ASAI-II级拟在硬膜外麻醉下行剖宫产手术的产妇,随机分为芬太尼组(F组,n=40)和纳布啡组(N组,n=40)。于胎儿取出后分别静脉给予芬太尼0.15ug/kg、纳布啡0.15mg/kg,对比两组循环呼吸变化及牵拉痛的发生情况。结果F组HR、MAP及RR均下降(P<0.05),并且有5例出现舌后坠需托下颌辅助呼吸,而N组HR、MAP及RR无明显变化(P>0.05),无舌后坠出现;牵拉痛发生情况:F组轻度疼痛23例,中度疼痛6例,发生率为72.5%,而N组仅6例出现轻度疼痛,发生率为15%。结论纳布啡应用于硬膜外麻醉剖宫产术中安全有效、循环稳定、牵拉痛发生率低,值得临床推广。Objective To observe the preventive effect of nalbuphine on the traction pain of cesarean section under epidural anesthesia.Methods 80 cases of cesarean section under epidural anesthesia were randomly divided into 2 groups, 40 cases in each group. Intravenous administration after the fetuses taking out:Group F received Fentanyl 0.15 ug/kg;group N received nalbuphine 0.15 mg/kg.Observed and compared the changes of circulatory、respiration and the incidence of traction pain.Results HR, MAP and RR decreased in group F(P<0.05),and there were 5 cases of glossoptosis and need to support mandibular assisted breathing.But there was no obvious change in HR, MAP and RR in group N(P >0.05),no glossoptosis occur;The occurrence of traction pain:there were 23 cases of mild pain and 6 cases of moderate pain in group F,the rate of occurrence is 72.5%.But Only 6 cases in group N had mild pain,the rate of occurrence is 15%.Conclusion nalbuphine should be used in epidural anesthesia for cesarean section safely and effectively, with stable circulation and low incidence of traction pain.It is worthy of clinical promotion.

关 键 词：纳布啡 硬膜外麻醉 剖宫产 牵拉痛 

分 类 号：R614[医药卫生—麻醉学]