右美托咪定联合氢吗啡酮硬膜外注射在剖宫产术后镇痛中的应用  

Application of Dexmedetomidine Combined with Hydromorphone Epidural Injection in Postoperative Analgesia after Cesarean Section

作　　者：高莹 GAO Ying(Ezhou Maternal and Child Health Hospital,Ezhou 436000,China)

机构地区：[1]鄂州市妇幼保健院,湖北鄂州436000

出　　处：《中外医学研究》2021年第36期175-178,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨右美托咪定联合氢吗啡酮硬膜外注射对剖宫产术后镇痛效果的影响。方法:选取2019年8月-2020年8月本院行择期剖宫产的100例孕妇为研究对象,应用随机数字表简单随机分组为对照组(n=50)和观察组(n=50)。胎儿娩出后,观察组依次予以右美托咪定1μg/kg、氢吗啡酮0.4 mg硬膜外注射,对照组则依次予以生理盐水(与右美托咪定等体积)、氢吗啡酮0.4 mg硬膜外注射。两组术后均使用PCIA予以补救镇痛,维持视觉模拟评分(VAS)≤3分;记录两组术后4、8、16、24、48 h的Ramsay镇静评分,并记录两组首次使用PCIA时间、PCIA给药总量、镇痛满意度评分及不良反应情况。结果:相比对照组,观察组术后4 h Ramsay镇静评分高(P<0.05),其他时间点的Ramsay镇静评分比较差异均无统计学意义(P>0.05)。相比对照组,观察组首次使用PCIA时间晚,PCIA给药总量少,镇痛满意度评分高。观察组术后恶心呕吐、皮肤瘙痒发生率均明显低于对照组(P<0.05)。结论:右美托咪定联合氢吗啡酮硬膜外注射能够优化剖宫术后镇痛效果,减少恶心呕吐、皮肤瘙痒发生。Objective:To investigate the effect of epidural injection of Dexmedetomidine combined with Hydromorphone on analgesia after cesarean section.Method:A total of 100 pregnant women who underwent elective cesarean section in our hospital from August 2019 to August 2020 were selected as the research objects,and were simply randomly divided into control group(n=50)and observation group(n=50)by random number table.After delivery,the observation group was successively given Dexmedetomidine 1μg/kg,Hydromorphone 0.4 mg epidural injection,while the control group was successively given normal saline(the same volume as Dexmedetomidine),Hydromorphone 0.4 mg epidural injection.PCIA was used for postoperative remedial analgesia,and the visual analogue scale(VAS)was≤3 points.The Ramsay sedation scores in the two groups at 4,8,16,24,48 h after operation were recorded,and the time of first use of PCIA,total dosage of PCIA,analgesic satisfaction score and adverse reactions were recorded.Result:Compared with the control group,the Ramsay sedation score of the observation group was higher at 4 h after operation(P<0.05),and there were no significant differences in Ramsay sedation scores at other time points(P>0.05).Compared with the control group,the first use of PCIA in the observation group was later,the total dosage of PCIA in the observation group was less,and the analgesic satisfaction score in the observation group was higher(P<0.05).The incidence of postoperative nausea,vomiting and skin itching in the observation group was significantly lower than those in the control group(P<0.05).Conclusion:Epidural injection of Dexmedetomidine combined with Hydromorphone can optimize the analgesic effect after cesarean section and reduce the occurrence of nausea,vomiting and skin itching.

关 键 词：右美托咪定 氢吗啡酮 硬膜外注射 剖宫产 镇痛 

分 类 号：R614[医药卫生—麻醉学]