右美托咪定复合甲磺酸罗哌卡因对剖宫产硬膜外麻醉产妇的镇静效果及血流动力学的影响  

Effects of Dexmedetomidine Combined with Ropivacaine Mesylate on Sedation and Hemodynamics of Cesarean Section and Epidural Anesthesia

作　　者：王慧慧 李秀贤[1] WANG Huihui;LI Xiuxian(Department of Anesthesiology,Jiaxiang County People´s Hospital,Jining,Shandong Province,272400 China)

机构地区：[1]嘉祥县人民医院麻醉科,山东济宁272400

出　　处：《中外医疗》2022年第17期104-108,共5页China & Foreign Medical Treatment

摘　　要：目的探讨对剖宫产硬膜外麻醉产妇采用右美托咪定复合甲磺酸罗哌卡因方案的镇静效果及对稳定血流动力学指标的作用。方法随机选择2020年1—12月嘉祥县人民医院收治的剖宫产产妇80例,按照随机数表法分为两组。对照组(n=40)应用甲磺酸罗哌卡因麻醉,观察组(n=40)联合右美托咪定麻醉,评价两组产妇麻醉效果,分析产妇麻醉前后各时间节点Ramsay镇静评分及麻醉前后的血流动力学指标,并统计两组产妇不良反应发生率。结果观察组麻醉优良率为95.00%,高于对照组的80.00%,差异有统计学意义(χ^(2)=4.114,P<0.05)。观察组麻醉后20 min、娩出胎儿时的Ramsay镇静评分分别为(2.19±0.41)分、(2.22±0.42)分,均高于对照组,差异有统计学意义(t=2.760、3.367,P<0.05)。观察组麻醉后心率(97.52±5.07)次/min、收缩压(102.37±6.56)mmHg、舒张压(62.09±4.35)mmHg均小于对照组,差异有统计学意义(t=3.442、3.874、4.650,P<0.05)。观察组不良反应发生率2.50%低于对照组20.00%,差异有统计学意义(χ^(2)=4.507,P<0.05)。结论对剖宫产硬膜外麻醉产妇采用右美托咪定复合甲磺酸罗哌卡因方案麻醉,镇静效果均理想,能够改善产妇的血流动力学指标,且可降低产妇的不良反应风险。Objective To investigate the sedative effect of dexmedetomidine combined with ropivacaine mesylate in cesarean section and epidural anesthesia and its effect on stabilizing hemodynamic indexes.Methods Randomly selected 80 cases of cesarean section parturients treated in Jiaxiang County People´s Hospital from January to December 2020 were randomly divided into two groups.The control group(n=40)was anesthetized with ropivacaine mesylate,and the observation group(n=40)was anesthetized with dexmedetomidine to evaluate the anesthesia effect of the two groups of pregnant women,analyzed the ramsay sedation score at each time node before and after anesthesia and the hemodynamic indexes before and after anesthesia,and counted the incidence of adverse reactions of the two groups of pregnant women.Results The excellent and good rate of anesthesia in the observation group was 95.00%higher than 80.00%in the control group,the difference was statistically significant(χ^(2)=4.114,P<0.05).The ramsay sedation scores of the observation group 20 minutes after anesthesia and at the time of delivery of the fetus were(2.19±0.41)points and(2.22±0.42)points were significantly higher than those of the control group,the difference was statistically significant(t=2.760,3.367,P<0.05).The heart rate(97.52±5.07)beats/min,systolic blood pressure(102.37±6.56)mmHg and diastolic blood pressure(62.09±4.35)mmHg in the observation group were significantly lower than those in the control group,the difference was statistically significant(t=3.442,3.874,4.650,P<0.05).The incidence of adverse reactions in the observation group was 2.50%lower than 20.00%in the control group,and the difference was statistically significant(χ^(2)=4.507,P<0.05).Conclusion Dexmedetomidine combined with ropivacaine mesylate for cesarean section and epidural anesthesia has satisfactory anesthetic and sedative effects,can improve the patient´s hemodynamic indicators,and reduce the risk of adverse reactions.

关 键 词：硬膜外麻醉 剖宫产 右美托咪定 罗哌卡因 镇静 血流动力学 

分 类 号：R4[医药卫生—临床医学]