右美托咪定注射液用于腰硬联合麻醉剖腹产术后腰痛的观察  

Therapeutic effect of dexmedetomidine injection against low back pain after caesarean section with combined spinal epidural anesthesia

作　　者：闫星[1] 唐晨[1] 林娜[1] YAN Xing;TANG Chen;LIN Na(Department of Anesthesiology,Beijing Tongren Hospital of Capital Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院麻醉科,北京100730

出　　处：《空军医学杂志》2020年第5期414-417,共4页Medical Journal of Air Force

摘　　要：目的腰痛是椎管内麻醉剖腹产术后最常见的并发症之一,可能导致患者术后不适及满意度下降。本研究旨在探讨右美托咪定注射液对于剖腹产术后腰痛的疗效。方法选取90例拟行剖腹产的初产妇,随机分为3组:右美托咪定组(A组),地塞米松组(B组),对照组(C组)各30例,分别于术毕接受右美托咪定注射液,地塞米松注射液及生理盐水硬膜外腔注射。比较3组产妇的血液动力学参数,包括收缩压和舒张压,心率,外周血氧饱和度以及术后腰痛发生率,视觉模拟量表(VAS)评分,患者满意度及不良反应发生情况。结果3组在麻醉时及麻醉后5、15、30、45 min时刻血流动力学及外周血氧饱和度(SpO2)差异无统计学意义,术后1、2 h B组的收缩压和舒张压及心率与A组和C组比较差异有统计学意义(P<0.05)。A组与B组之间腰痛发生率、VAS评分、产妇满意度差异无统计学意义(P>0.05),与C组比较差异有统计学意义(P<0.05)。A组不良反应少于B组,差异有统计学意义(P<0.05)。结论右美托咪定注射液缓解术后腰痛的效果与地塞米松注射液相似,而不良作用明显减少。右美托咪定注射液更适合用于缓解腰硬联合麻醉剖宫产术后腰痛。Objective To investigate the therapeutic effect of dexmedetomidine injection against low back pain(LBP)that is one of the most frequent complications after caesarean section with combined spinal epidural anesthesia and may lead to poor patient satisfaction.Methods Ninety pregnant women were randomly divided into three equal groups:group A that received dexmedetomidine injection,group B that was administered with dexamethasone injection,and group C that was given saline injection post-operatively.Hemodynamic parameters,including systolic and diastolic blood pressure,heart rate and peripheral oxygenation saturation,were recorded.In addition,the incidence of low back pain,visual analog scale(VAS)pain scores,maternal satisfaction and side effects were recorded.Results There was no significant difference between the three groups at the start of anesthesia(T0),5 minutes(T1),15 minutes(T2),30 minutes(T3),and 45 minutes(T4)after anesthesia.At 1 hour(T5)and 2 hours(T6)postoperatively,systolic blood pressure(SBP)and diastolic blood pressure(DBP)in group B were lower than in the other two groups.Heart rate(HR)in group B was significantly more tachycardic than in the other two groups(P<0.05).The incidence of low back pain,VAS scores,and maternal satisfaction in groups A and B were similar(P<0.05),but were better than in group C(P>0.05).There were significantly fewer inflammation mediators and side effects in group A than in group B(P<0.05).Conclusion Dexmedetomidine injection is as effective for low back pain as dexamethasone,with fewer side effects,so it is more suitable for low back pain after caesarean section with combined spinal epidural anesthesia.

关 键 词：右美托咪定 腰痛 剖腹产 腰硬联合麻醉 

分 类 号：R614[医药卫生—麻醉学]