右美托咪定预先给药联合术中持续泵注在剖宫产麻醉中的应用  

Application of Dexmedetomidine Pretreatment Combined with Intraoperative Continuous Pump Injection in Cesarean Section Anesthesia

作　　者：郭国庆 林彩玲 郑彬耀 吴建文 沈龙源 许艺彬 肖全胜 GUO Guoqing;LIN Cailing;ZHENG Binyao;WU Jianwen;SHEN Longyuan;XU Yibin;XIAO Quansheng(Quanzhou Women’s and Children’s Hospital·Children’s Hospital,Quanzhou 362000,China)

机构地区：[1]泉州市妇幼保健院·儿童医院,福建泉州362000

出　　处：《中外医学研究》2022年第30期130-133,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探究右美托咪定预先给药联合术中持续泵注在剖宫产麻醉中的应用价值。方法:选取2021年1-12月泉州市妇幼保健院·儿童医院妇产科收治的单胎足月妊娠行剖宫产手术的产妇120例。随机单盲法分为试验组和对照组,每组60例。试验组诱导前10 min静脉泵注右美托咪1μg/kg,后进行持续泵入[0.4μg/(kg·h)],对照组使用等量氯化钠注射液进行替换。记录两组手术时间、入量、出血量和尿量;记录两组麻醉前(T_(0))、给药10 min后(T_(1))、切皮时(T_(2))、切皮30 min后(T_(3))和手术结束时(T_(4))的心率、收缩压、舒张压、血糖和皮质醇水平;记录新生儿出生1、5 min时的Apgar评分,对新生儿脐静脉血气指标进行评估。结果:试验组出血量少于对照组,尿量多于对照组(P<0.05)。T_(0)、T_(1)、T_(4)时,两组的心率、收缩压、舒张压、血糖和皮质醇水平比较,差异无统计学意义(P>0.05);T_(2)、T_(3)时,试验组的心率、收缩压、舒张压、血糖和血清皮质醇水平均低于对照组(P<0.05)。两组新生儿出生1 min与5 min时的Apgar评分、pH、二氧化碳分压(PaCO_(2))、血氧分压(PaO_(2))和血氧饱和度(SaO_(2))等指标比较,差异均无统计学意义(P>0.05)。结论:右美托咪定预先给药联合术中持续泵注用于剖宫产术的麻醉效果较好,且对产妇及新生儿影响较小,新生儿血流动力学更平稳。Objective:To explore the application value of Dexmedetomidine pretreatment combined with intraoperative continuous pump injection in cesarean section anesthesia.Method:A total of 120 full-term singleton puerperae who underwent cesarean section in the Department of Obstetrics and Gynecology of the Quanzhou Women’s and Children’s Hospital·Children’s Hospital from January and December 2021 were selected.They were divided into experimental group and control group by random single-blind method,60 cases in each group.The experimental group was given intravenous infusion of 1μg/kg of Dexmedetomidine at 10 minutes before induction,followed by continuous pumping[0.4μg/(kg·h)],while the control group was treated with the equal amount of Sodium Chloride Injection.Operation time,infusion volume,blood loss and urine volume of the two groups were recorded.The heart rate,systolic blood pressure,diastolic blood pressure,blood glucose and cortisol levels before anesthesia(T_(0)),at 10 min after administration(T_(1)),at skin incision(T_(2)),at 30 minutes after skin incision(T_(3))and at the end of operation(T_(4))were recorded in both groups.Neonatal Apgar scores at 1 and 5 minutes after birth were recorded.The neonatal umbilical vein blood gas indexes were evaluated.Result:The blood loos in the experimental group was less than that in the control group,and urine output was more than that in the control group(P<0.05).There were no significant differences in heart rate,systolic blood pressure,diastolic blood pressure,blood glucose and cortisol levels between the two groups at T_(0),T_(1) and T_(4)(P>0.05).At T_(2) and T_(3),the heart rate,systolic blood pressure,diastolic blood pressure,blood glucose and serum cortisol levels in the experimental group were lower than those in the control group(P<0.05).There were no significant differences between the two groups in terms of neonatal Apgar scores at 1 and 5 minutes after birth,pH,partial pressure of carbon dioxide(PaCO_(2)),partial pressure of oxygen(PaO_(2))and blood oxyge

关 键 词：剖宫产术 新生儿 右美托咪定 麻醉药 联用 

分 类 号：R614[医药卫生—麻醉学]