右美托咪定复合不同浓度罗哌卡因对妊娠高血压综合征患者分娩镇痛的疗效随机对照研究  

A randomized controlled study on the effect of dexmedetomidine combined with ropivacaine of different concentrations on labor analgesia in patients with PIH

作　　者：严百惠 田龙飞 罗斌[1] Yan Bai-hui;Tian Long-fei;Luo Bin(Department of Anesthesiology,The Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China;Dali County Maternal and Child Health Hospital,Dali 715100,Shaanxi,China)

机构地区：[1]西安交通大学第二附属医院麻醉科,陕西西安710004 [2]大荔县妇幼保健院,陕西大荔715100

出　　处：《兰州大学学报（医学版）》2021年第2期81-85,共5页Journal of Lanzhou University（Medical Sciences）

基　　金：陕西省医学科学研究重点课题计划项目(2016JM3979)。

摘　　要：目的分析在妊娠高血压综合征患者分娩镇痛中采用右美托咪定复合不同浓度罗哌卡因的疗效。方法选择2017年10月—2018年8月在西安交通大学第二附属医院足月分娩的76例妊娠高血压综合征产妇,根据自愿原则随机分为2组,2组产妇均接受硬膜外麻醉及自控镇痛,同时给予0.5μg/kg右美托咪定,在此基础上对照组(38例)复合给予0.2%罗哌卡因,实验组(38例)复合给予0.1%罗哌卡因。记录2组产妇在不同时段平均动脉压和心率情况;通过视觉模拟(VAS)评分和Ramsay镇静评分统计2组产妇在不同时段疼痛和镇静程度;通过Apgar评分评估新生儿情况并观察胎心率;调查2组产妇产程时间,记录不良反应发生情况。结果在各时间点上,2组患者平均动脉压以及心率差异无统计学意义(P>0.05);对比各时间点VAS评分和Ramsay镇静评分,实验组均优于对照组,差异有统计学意义(P<0.05);2组患者在Apgar评分及胎心率上差异无统计学意义(P>0.05);实验组在第一及第二产程时间上与对照组差异无统计学意义(P>0.05);实验组不良反应发生率明显低于对照组,差异有统计学意义(P<0.05)。结论右美托咪定复合不同浓度罗哌卡因应用于妊娠高血压综合征患者分娩镇痛中均能取得良好的麻醉效果,可减轻患者疼痛,维持生命体征的稳定,抑制不良反应,可推荐应用于临床。Objective To analyze the effect of dexmedetomidine combined with different concentrations of ropivacaine on labor analgesia in patients with PIH.Methods Selected 76 pregnant women with PIH and giving birth at term in The Second Affiliated Hospital of Xi'an Jiaotong University,from October 2017 to August 2018.According to the principle of voluntariness,they were randomly divided into two groups,both receiving epidural anesthesia and self-control analgesia,and 0.5μg/kg dexmedetomidine.On this basis,the control group(38 cases)was added with 0.2%ropivacaine,and the experimental group(38 cases)with 0.1%.The average arterial pressure and heart rate of the two groups were recorded in different periods;the pain and sedation degree of the two groups were counted by VAS score and Ramsay sedation score in different periods;the newborn was evaluated by Apgar score and its fetal heart rate was observed;the times of the two groups was investigated and the occurrence of adverse reactions was recorded.Results At each time point,there was no significant difference in the mean arterial pressure and heart rate between the two groups(P>0.05).Compared with the VAS score and Ramsay sedation score at each time point,the experimental group was superior to the control group and the difference was statistically significant(P<0.05).There was no significant difference in the Apgar score and fetal heart rate between the two groups(P>0.05).The experimental group was in the first and second stage of labor,compared with the control,the difference between them was small,and there was no statistical significance(P>0.05).The incidence of adverse reactions in the experimental group was significantly lower than in the control group,and the difference was statistically significant(P<0.05).Conclusion Dexmedetomidine combined with ropivacaine of different concentrations can achieve good anesthetic effect in the labor analgesia of PIH patients,thus can reduce the pain of patients,maintain the stability of vital signs,inhibit adverse reactions and can b

关 键 词：妊娠高血压综合征 分娩 右美托咪定 镇痛 罗哌卡因 

分 类 号：R614[医药卫生—麻醉学]