剖宫产纳布啡合联合舒芬太尼静脉自控镇痛效果及对产妇应激反应和安全性影响  

Effet of nalbuphine combined with sufentanil for patient-controlled intravenous analgesia of women after cesarean section and its inflvence on the stress reaction and the safety of the women

作　　者：胡利 李云 朱免免 赵恒 HU Li;LI Yun;ZHU Waimian;ZHAO Heng(Huaibei Maternal and Child Health Care Hospilal,Anhui Prorince,235000;Huaibei Peoples Hospial of Anhui Province)

机构地区：[1]安徽省淮北市妇幼保健院,235000 [2]安徽省淮北市人民医院

出　　处：《中国计划生育学杂志》2023年第7期1576-1580,共5页Chinese Journal of Family Planning

摘　　要：目的:探讨纳布啡联合舒芬太尼应用在剖宫产静脉自控镇痛(PCIA)对产妇应激反应、视觉模拟评分法(VAS)、疗效及安全性的影响。方法:选取2020年5月—2022年4月于本院行PCIA的剖宫产产妇100例,电脑随机分组为观察组(52例)和对照组(48例),对照组辅以舒芬太尼自控镇痛,观察组在对照组基础上联用纳布啡;观察两组术前术后去甲肾上腺素(NE)、肾上腺素(E)、多巴胺(DA)水平,术后12h、24h、48hVAS评分及Ramsay镇静评分,术后恢复及不良反应。结果:观察组术后NE、E、DA水平均较术前上升但观察组低于对照组(P<0.05);两组术后Ramsay评分及术后12hVAS评分无差异(P>0.05),观察组术后24h(3.0±0.4分)、48h(2.0±0.2分)VAS评分均低于对照组(3.9±0.8分、2.7±0.5分),镇痛满意度(96.2%)高于对照组(66.7%),术后自主排尿时间(18.5±2.6h)及术后首次下床时间(12.1±2.3h)低于对照组(26.8±2.0h、16.4±2.1h),镇痛持续时间(41.2±2.2h)长于对照组(28.1±2.0h),不良反应总发生率(5.8%)低于对照组(22.9%)(均P<0.05)。结论:剖宫产产妇PCIA中应用纳布啡联合舒芬太尼可更有效缓解疼痛及应激反应,促进术后恢复,减少不良反应,提高产妇术后满意度。Objective:To explore the influence of nalbuphine combined with sulentanil for patient-controlled intravenous analgeia(PCIA)of women after cesarean section on the maternal stress response,visual analogue scale(VAS)score.curative effect.and salety.Methods:A total of 100 women after cesarean section were selected and were divided obser-vation group(52 cases with sufentanil for PCIA)and control group(48 cases with nalbuphine combined with sufentanil for PCIA)according to the computer randomization method from May 2020 to April 2022.The levels of norepinephrine(NE),epinephrine(E),and dopamine(DA)of the women in the two groups before and after operation were ob-served.The VAS scores and Ramsay sedation scores,the postoperative sitwation,and the postoperative adverse reac-tions rate of the women in the two groups at 12h,24h,and 48h after operation were also observed.Results:The NE,E,and DA levels of the women in the observation group were significantly higher than those of the women before sur-gery.but which of the women in the observation group were significantly lower than those of the women in the control group(P<0.05).The Ramsay score of the women after surgery and the VAS score in 12h after surgery of the women had no significant differences between the two groups(P>0.05).The VAS score of the women in the observation group in 24h(3.0±0.4 points)and in 48h(2.0±0.2 points)after surgery were signifiantly lower than those(3.9±0.8 points and 2.7±0.5 points)of the women in the control group.The analgesic satisfaction(96.2%)of the women in the observation group was significantly higher than that(66.7%)of the women in the control group.The time of spontane-ous urination(18.5±2.6h)and the time of first getting out of bed(12.1±2.3h)of the women in the observation group were significantly lower than those(26.8±2.0h and 16.4±2.1h)of the women in the control group.The duration of analgsia(41.2±2.2h)of the women in the observation group was significanly longer than that(28.1±2.0h)of the women in the control group.and t

关 键 词：剖宫产术后镇痛 静脉自控镇痛 纳布啡 舒芬太尼 应激反应 镇痛效果 术后恢复 满意度 

分 类 号：R614[医药卫生—麻醉学]