不同剂量右美托咪定复合布托啡诺硬膜外麻醉辅助分娩镇痛临床评价  

Clinical Evaluation of Different Doses of Dexmedetomidine Combined with Butorphanol Epidural Anesthesia Assisted Labor Analgesia

作　　者：田利川 王圣华 赵贺 刘海涛 李亚华 戚娟 王月新 TIAN Lichuan;WANG Shenghua;ZHAO He;LIU Haitao;LI Yahua;QI Juan;WANG Yuexin(Cangzhou People's Hospital,Cangzhou,Hebei,China 061000)

机构地区：[1]河北省沧州市人民医院,河北沧州061000

出　　处：《中国药业》2022年第20期94-97,共4页China Pharmaceuticals

基　　金：河北省2020年度医学科学研究课题[20200297]。

摘　　要：目的探讨不同剂量右美托咪定复合布托啡诺硬膜外麻醉用于产妇辅助分娩镇痛的效果。方法选取医院2018年1月至2020年12月收治的足月分娩产妇120例,按随机数字表法分为对照组和试验组,各60例。两组产妇分娩前均行硬膜外麻醉、置管前、置管后分别予盐酸利多卡因注射液行局部浸润麻醉及分娩前预麻醉。对照组、试验组产妇分别予小剂量[0.15μg/(kg·h)]、大剂量[0.20μg/(kg·h)]盐酸右美托咪定注射液联合酒石酸布托啡诺注射液10 mg缓慢(2 mL/h)注射,产后予注射用盐酸罗哌卡因6 mL/h硬膜外泵注行患者自控镇痛。结果镇痛后,两组产妇的前列腺素E、P物质、5-羟色胺水平较镇痛前均显著降低(P<0.05),且试验组显著低于对照组(P<0.05);两组产妇的肿瘤坏死因子-α、白细胞介素6、C反应蛋白水平及去甲肾上腺素、皮质醇水平较镇痛前均显著降低(P<0.05),且试验组显著低于对照组(P<0.05)。两组镇痛前、镇痛即刻时视觉模拟量表(VAS)评分及Ramsay量表评分相当(P>0.05),但试验组镇痛10 min、镇痛30 min时VAS评分均显著低于对照组(P<0.05),Ramsay量表评分显著高于对照组(P<0.05)。试验组与对照组不良反应发生率相当(6.65%比4.98%,P>0.05)。结论大剂量右美托咪定复合布托啡诺用于分娩镇痛可提升镇痛、镇静效果。Objective To investigate the effect of different doses of dexmedetomidine combined with butorphanol epidural anesthesia assisted labor analgesia in the parturients.Methods A total of 120 full-term parturients admitted to the hospital from January2018 to December 2020 were selected and divided into the control group and the test group by the random number table method,with 60 cases in each group.The parturients in the two groups received epidural anesthesia before delivery,and they were given Lidocaine Hydrochloride Injection for local infiltration anesthesia and pre-anesthesia before and after catheter placement.The parturients in the control group and the test group were respectively given low-dose[0.15μg/(kg·h)]and high-dose[0.20μg/(kg·h)]Dexmedetomidine Hydrochloride Injection combined with Butorphanol Tartrate Injection(10 mg)slowly(2 mL/h),and they were given Ropivacaine Hydrochloride for Injection(6 mL/h)through the patient-controlled epidural analgesia(PCEA)after delivery.Results After analgesia,the levels of prostaglandin E(PGE),substance P(SP)and 5-hydroxytryptamine(5-HT)in the two groups were significantly lower than those before analgesia(P<0.05),and those in the test group were significantly lower than those in the control group(P<0.05).The levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP),norepinephrine(NE)and cortisol(Cor)in the two groups were significantly lower than those before analgesia(P<0.05),and those in the test group were significantly lower than those in the control group(P<0.05).The visual analogue scale(VAS)scores and Ramsay scores before analgesia(T)and immediately after analgesia(T)were similar in the two groups(P>0.05),the VAS scores at 10 min(T)and 30 min(T)of analgesia in the test group were significantly lower than those in the control group(P<0.05),while the Ramsay scores at T2and T3of analgesia in the test group were significantly higher than those in the control group(P<0.05).The incidence of adverse drug reactions in the test group was

关 键 词：右美托咪定 布托啡诺 复合麻醉 分娩镇痛 疼痛介质 炎性因子 

分 类 号：R969.4[医药卫生—药理学] R971.2[医药卫生—药学]