不同剂量舒芬太尼和纳布啡持续镇痛对剖宫产产妇术后VAS及Ramsay镇静评分影响的观察  

Effects of Different Doses of Sufentanil and Nalbuphine Continuous Analgesia on VAS and Ramsay Sedation Score after Cesarean Section

作　　者：王璐 张鹏[2] 张海鹰 周荣胜[4] 高媛媛[1] WANG Lu;ZHANG Peng;ZHANG Hai-ying;ZHOU Rong-sheng;GAO Yuan-yuan(Department of operation and anaesthesia,The Second Affiliated Hospital of Xi'an Medical university,Xi'an,Shaanxi,710038,China;Department of anesthesiology,The Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an,Shaanxi,710004,China;Department of anesthesiology,Tangdu Hospital,Xi'an,Shaanxi,710038,China;Department of anesthesiology,The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an,Shaanxi,710061,China)

机构地区：[1]西安医学院第二附属医院手麻科,陕西西安710038 [2]西安交通大学第二附属医院麻醉科,陕西西安710004 [3]唐都医院麻醉科,陕西西安710038 [4]西安交通大学第一附属医院麻醉科,陕西西安710061

出　　处：《现代生物医学进展》2023年第3期570-574,共5页Progress in Modern Biomedicine

基　　金：国家自然科学基金项目(81273902)。

摘　　要：目的:研究不同剂量舒芬太尼和纳布啡持续镇痛对剖宫产产妇术后镇痛和镇静效果的影响。方法:选取2020年1月到2021年12月在我院进行剖宫产分娩的产妇100例,根据术后镇痛使用舒芬太尼剂量的不同分为A组和B组,每组各50例。A组术后镇痛方案:1.0μg/kg舒芬太尼和1 mg/kg纳布啡,持续镇痛48小时;B组术后镇痛方案:2.0μg/kg舒芬太尼和1 mg/kg纳布啡,持续镇痛48小时。比较两组术后不同时间视觉模拟量表(VAS)评分和Ramsay评分。结果:(1)两组患者年龄、身高、体重、孕周、麻醉起效时间、胎儿分娩时间、手术时间和麻醉时间比较均无显著差异(P>0.05);(2)B组产妇术后48小时收缩压、舒张压、心率和血氧饱和度均显著低于A组产妇(P<0.05);(3)B组产妇术后6、24和48小时VAS评分均显著低于A组(P<0.05),而Ramsay评分却显著高于A组(P<0.05);(4)B组产妇术后不良反应发生率高于A组(16%vs 12%),但比较无统计学意义(P>0.05)。结论:舒芬太尼和纳布啡持续镇痛对剖宫产产妇具有较好的术后镇痛和镇静效果,提高舒芬太尼剂量镇痛镇静效果更好。Objective: To study the effect of different doses of sufentanil and nalbuphine for continuous analgesia on postoperative analgesia and sedation in cesarean section women. Methods: A total of 100 puerperae who underwent cesarean section in our hospital from January 2020 to December 2021 were selected and divided into group A and group B according to the different doses of sufentanil used for postoperative analgesia, with 50 cases in each group. Postoperative analgesia in group A: 1.0 μg/kg sufentanil and 1 mg/kg nalbuphine for 48 hours;group B postoperative analgesia: 2.0 μg/kg sufentanil and 1 mg/kg nalbuphine, sustained analgesia for 48 hours.Comparison of visual analog scale(VAS) scores and Ramsay scores at different times after surgery between the two groups. Results:(1)There were no significant differences in age, height, weight, gestational age, anesthesia onset time, fetal delivery time, operation time and anesthesia time between the two groups(P>0.05).(2) The systolic blood pressure, diastolic blood pressure, heart rate and blood oxygen saturation of puerperae in group B were significantly lower than those in group A at 48 hours after operation(P<0.05).(3) The VAS scores of puerperae in group B were significantly lower than those in group A at 6, 24 and 48 hours after operation(P<0.05), while the Ramsay score was significantly higher than that in group A(P<0.05).(4) The incidence of postoperative adverse reactions in group B was higher than that in group A(16 % vs 12 %), but the comparison was not significant(P>0.05). Conclusion: Sufentanil and nalbuphine for continuous analgesia have better postoperative analgesic and sedative effects on cesarean section women, and the analgesic and sedative effect of increasing the dose of sufentanil is better.

关 键 词：舒芬太尼 纳布啡 剖宫产 镇痛 镇静 

分 类 号：R719[医药卫生—妇产科学] R614[医药卫生—临床医学]