右美托咪定复合瑞芬太尼用于中期妊娠引产术的镇痛效果及安全性分析  

The analgesic effects and safety of dexmedetomidine combined with remifentanil in pregnant women undergoing induced labor in second trimester pregnancy

作　　者：吴军娜 李红[1] 张瑾[1] 李国芳[1] 刘叶 高义 邵娴[1] WU Junna;LI Hong;ZHANG Jin(Department of Anesthesia, The Fourth Hospital of Shijiazhuang City,Hebei, Shijiazhuang 050011,China)

机构地区：[1]河北省石家庄市第四医院麻醉科

出　　处：《河北医药》2020年第2期240-243,共4页Hebei Medical Journal

摘　　要：目的评价右美托咪定复合瑞芬太尼用于中期妊娠引产术患者镇痛效果及安全性。方法中期妊娠引产的患者40例按照随机数字法分为试验组和对照组,每组20例。对照组:瑞芬太尼负荷剂量0.5μg/kg,持续剂量0.05μg·kg-1·min-1,试验组:瑞芬太尼负荷剂量0.5μg/kg,持续剂量0.05μg·kg-1·min-1,右美托咪定负荷剂量0.5μg/kg持续剂量0.2μg·kg-1·h-1。记录患者给药前(T0),给药后10 min(T1)、30 min(T2)、60 min(T3)、宫开口开全时(T4)的心率(HR)、血压[收缩压(SBP)、舒张压(DBP)]、脉搏血氧饱和度(SpO2)、呼吸频率(RR),Ramsay镇静评分,脑电双频谱指数(BIS)值及发生的不良反应。结果T1~T3时,试验组的HR及呼吸频次变化不明显但高于对照组同期水平,差异有统计学意义(P<0.05);2组患者的Ramsay镇静评分均高于T0时,但试验组的镇静效果明显优于对照组,且试验组T2时Ramsay镇静评分达到最高,而对照组在T1时Ramsay镇静评分达到最高,差异有统计学意义(P<0.05);T1~T4时2组患者的BIS值均低于T0时,但T1~T3时试验组BIS值均低于对照组,且保持在轻中度镇静状态,差异有统计学意义(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论右美托咪定复合瑞芬太尼可安全应用于中期妊娠引产术中,并可获得安全有效的镇静镇静麻醉方案。Objective To evauate the analgesic effects and safety of dexmedetomidine combined with remifentanil in pregnant women undergoing induced labor in second trimester pregnancy.Methods A total of 40 pregnant women who underwent induced labor in second trimester pregnancy in our hospital from January 2017 to June 2017 were enrolled in the study,who were randomly divided into experimental group and control group,with 20 cases in each group.The pregnant women pregnant women in control group were treated by remifentanil with loading dose 0.5μg/kg,sustained dose 0.05μg·kg-1·min-1,however,the pregnant women in experimental group were treated by dexmedetomidine combined with remifentanil loading dose 0.5μg/kg,sustained dose 0.05μg·kg-1·min-1,dexmedetomidine loading dose 0.5μg/kg,sustained dose 0.2μg·kg-1·h-1.The heart rate,blood pressure,pulse oxygen saturation,respiratory frequency,Ramsay sedation score,BIS value and adverse reactions before(T0),10min(T1),30min(T2),60min(T3)and complete opening of uterine orifice(T4)were observed and comapred between the two groups.Results The changes of HR and respiratory frequency at T1~T3 in experimental group were not obvious,however,which were significantly higher than those in control group(P<0.05),moreover,the Ramsay sedation scores in both groups were higher than those at T0,but the sedation effects in experimental group were superior to those in control group,and the Ramsay sedation scores reached peak at T2 in experimental group,while the Ramsay sedation scores reached peak at T1 in control group,the difference was statistically significant(P<0.05).In addition the BIS values at T1~T4 in both groups were lower than those at T0,but the BIS values at T1~T3 in experimental group were significantly lower than those in control group(P<0.05).There were no significant differences in the incidence rates of adverse reactions between the two groups(P>0.05).Conclusion The dexmedetomidine combined with remifentanil can be safely applied in induction of labor in midpregnancy,which

关 键 词：右美托咪定 瑞芬太尼 中期妊娠引产 镇痛 安全性 

分 类 号：R971.2[医药卫生—药品]