不同剂量羟考酮防治二次剖宫产术中牵拉反应的效果  

Effect of different doses of Oxycodone in the treatment of traction reaction during the second cesarean section

作　　者：钱夏丽 陈雅洁 QIAN Xia-li;CHEN Ya-jie(Department of Anesthesiology,Women′s Hospital of Nanjing Medical University(Nanjing Maternity and Child Health Care Hospital),Jiangsu Province,Nanjing 210004,China)

机构地区：[1]南京医科大学附属妇产医院(南京市妇幼保健院)麻醉科,江苏南京210004

出　　处：《中国当代医药》2021年第25期128-131,共4页China Modern Medicine

摘　　要：目的评估不同剂量羟考酮防治二次剖宫产术中牵拉反应的效果。方法选取2019年10月—2020年12月于南京市妇幼保健院行择期连续硬膜外麻醉下二次剖宫产的120例产妇作为研究对象,根据随机数字表法将其分为O_(1)、O_(2)、O_(3)与C组,每组各30例。胎儿娩出后,O_(1)、O_(2)、O_(3)组产妇分别给予盐酸羟考酮注射液0.08、0.10、0.12 mg/kg静脉缓慢推入,C组产妇给予相同剂量的生理盐水。比较三组产妇的术中牵拉反应分级、入室时(T_(0))、给药前(T_(1))、给药后10 min(T_(2))和探查腹腔时(T_(3))、术毕(T_(4))的平均动脉压(MAP)、心率(HR)、脉搏氧饱和度(SpO_(2))以及T_(1)、T_(2)、T_(3)、T_(4)时的Ramsay评分。结果O_(2)、O_(3)组产妇的牵拉反应分级低于C组,差异有统计学意义(P<0.05);O_(1)组产妇的牵拉反应分级与C组比较,差异无统计学意义(P>0.05)。O_(1)、O_(2)、O_(3)、C组产妇T_(0)、T_(1)、T_(2)、T_(3)、T_(4)各时间点的MAP、HR比较,差异均无统计学意义(P>0.05)。O_(3)组产妇T_(2)、T_(3)、T_(4)时刻的SpO_(2)低于O_(1)、O_(2)、C组,差异有统计学意义(P<0.05)。O_(1)、O_(2)、O_(3)、C组产妇T_(1)时刻的Ramsay镇静评分比较,差异无统计学意义(P>0.05);O_(2)、O_(3)组产妇T_(2)、T_(3)、T_(4)时刻的Ramsay镇静评分高于O_(1)、C组,差异有统计学意义(P<0.05)。结论二次剖宫产术中静脉使用盐酸羟考酮可以为手术提供良好的镇静效果,并减轻牵拉反应的程度,且在胎儿娩出后给予产妇0.10 mg/kg盐酸羟考酮可以提供良好的镇静效果并充分抑制术中牵拉痛,使产妇的生命体征更加平稳。Objective To evaluate the effect of different doses of Oxycodone in the treatment of traction reaction during second cesarean section.Methods One hundred and twenty multiparas who underwent second cesarean section in Nanjing Maternity Child Health Care Hospital from October 2019 to December 2020 were selected as the research objects.According to the random number table method,they were divided into O_(1),O_(2),O_(3) and C groups,with 30 cases in each group.After the fetus was delivered,group O_(1),O_(2),and O_(3) were given Oxycodone Hydrochloride Injection 0.08,0.10,0.12 mg/kg,respectively.Group C was given the same dose of normal saline.The mean arterial pressure(MAP),heart rate(HR),saturation of pulse oximetry(SpO_(2))in the entering the room(T_(0)),before administration(T_(1)),10 min after administration(T_(2)),when exploring the abdominal cavity(T_(3)),and after operation(T_(4)),Ramsay scores at T_(1),T_(2),T_(3) and T_(4) were compared among the three groups.Results The grading of the pull reaction in groups O_(2) and O_(3) were lower than that of the group C,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the grading of traction response between group O_(1) and group C(P>0.05).There were no statistically significant differences in MAP and HR at T_(0),T_(1),T_(2),T_(3) and T_(4) among group O_(1),O_(2),O_(3) and C(P>0.05).The SpO_(2) level of group O_(3) was lower than that of group O_(1),O_(2) and C at T_(2),T_(3) and T_(4),and the differences were statistically significant(P<0.05).At T_(1),there was no statistically significant difference in Ramsay scores among the group O_(1),O_(2),O_(3) and C(P>0.05).The Ramsay scores in groups O_(2) and O_(3) were higher than those in groups O_(1) and C at T_(2),T_(3) and T_(4),and the differences were statistically significant(P<0.05).Conclusion After the fetus was delivered,Oxycodone Hydrochloride Injection can provide good sedative and relieve the visceral traction response during the secondary cesarean

关 键 词：二次剖宫产 连续硬膜外麻醉 羟考酮 牵拉反应 镇静 

分 类 号：R614[医药卫生—麻醉学]