酮咯酸复合右美托咪定应用于剖宫产术后PCIA临床观察  

Clinical observation of ketorolac combined with dexmedetomidine in PCIA after cesarean section

作　　者：王军[1] 周清梓 李敏[2] 赵亚宁[3] 刘康 王露[1] 王娟[1] 刘欢[1] WANG Jun;ZHOU Qing-zi;LI Min;ZHAO Ya-ning;LIU Kang;WANBG Lu;WANG Juan;LIU Huan(Second Affiliated Hospital of Shanxi University of Traditional Chinese Medicine,1.Department of anesthesiology,Shanxi Xianyang 712021,China;Second Affiliated Hospital of Shanxi University of Traditional Chinese MedicineDelivery Room,Shanxi Xianyang 712021,China;Second Affiliated Hospital of Shanxi University of Traditional Chinese Medicine,One Department of Obstetrics,Shanxi Xianyang 712021,China)

机构地区：[1]陕西中医药大学第二附属医院麻醉科,陕西咸阳712021 [2]陕西中医药大学第二附属医院产房,陕西咸阳712021 [3]陕西中医药大学第二附属医院产一科,陕西咸阳712021

出　　处：《临床医药文献电子杂志》2020年第18期17-18,36,共3页Electronic Journal of Clinical Medical Literature

摘　　要：目的探讨酮咯酸氨丁三醇联合右美托咪啶应用于剖宫产术后镇痛的效果及不良反应。方法在此项临床试验研究中,我们选择我院(陕西中医药大学第二附属医院,以下简称"我院")2016年1月至2018年10月,ASAⅠ级和Ⅱ级择期剖宫产产妇且愿意接受PCIA治疗,共计300例,随机分为三组,每组100例:酮咯酸氨丁三醇复合右美托咪定组(A组)、酮咯酸氨丁三醇组(B组)、舒芬太尼组(C组),比较三组1 h(T1)、3 h(T2)、6 h(T3)、12 h(T4)、24 h(T5)的镇痛效果及不良反应。所有患者术后视觉模拟评分法(Visual Analogue Scale/Score,VAS)评分≥4分时给予舒芬太尼5μg进行抢救性镇痛。记录有效自控镇痛泵按压次数状况及抢救镇痛例数。结果酮咯酸氨丁三醇复合右美托咪定组(A组)镇痛效果优于B组、C组,差异有统计学意义(P<0.05),不良反应如皮肤瘙痒、恶心呕吐、头晕低于其他组。B组术后自控镇痛按压次数高于A、C组,及B组应用抢救性镇痛救药物例数显著高于A、C组。结论酮咯酸氨丁三醇复合右美托咪定在剖宫产术后镇痛的作用优于单纯使用酮咯酸或者舒芬太尼且恶心呕吐发生率明显降低,可以作为剖宫产术后镇痛去阿片化的主要药物。Objective To investigate the analgesic effect and adverse reactions of Ketorolac Tromethamine combined with dexmedetomidine after cesarean section.Methods In this clinical trial study,we selected our hospital (the second affiliated Hospital of Shaanxi University of traditional Chinese Medicine,hereinafter referred to as "our hospital"),from January 2016 to October 2018,300 ASA I and II elective cesarean section women were randomly divided into three groups:ketorolac tromethamine combined with dexmedetomidine group (group A),ketorolac tromethamine group (group B),and Shu.The analgesic effects and adverse reactions of 1 h (T1),3 h (T2),6 h (T3),12 h(T4) and24 h(T5) of fentanyl group were compared.All patients were given sufentanil 5 μg for salvage analgesia when the visual analogue scale/Score (VAS) score was greater than or equal to 4 minutes.Record the number of pressing times and the number of rescue and analgesia cases of effective self-controlled analgesia pump.Results The analgesic effect of ketorolac tromethamine combined with dexmedetomidine group (group A) was better than that of group B and group C (P < 0.05).The adverse reactions such as skin itching,nausea and vomiting,dizziness were lower than those of other groups.The number of PCA pressing in group B was higher than that in group A and C,and the number of rescue analgesics in group B was significantly higher than that in group A and C.Conclusion The analgesic effect of ketorolac tromethamine combined with dexmedetomidine after cesarean section is better than that of ketorolac or sufentanil alone,and the incidence of nausea and vomiting is significantly reduced.It can be used as the main analgesic and opioid-free drμg after cesarean section.

关 键 词：酮咯酸氨丁三醇 右美托咪定 静脉自控镇痛 剖宫产 

分 类 号：R719.8[医药卫生—妇产科学]