地佐辛联合舒芬太尼在剖宫产术后持续硬膜外镇痛中的效果观察  

Effects of dezocine combined with sufentanil on continuous epidural analgesia after cesarean section

作　　者：郭金辉 耿兴强 张野[2] Guo Jinhui;Geng Xingqiang;Zhang Ye(Department of Anesthesiology,Guoyang Hospital of Traditional Chinese Medicine,Bozhou 233600,Anhui Province,China;Department of Anesthesiology and Perioperative Medicine,The Second Hospital of Anhui Medical University,Hefei 230601,Anhui Province,China)

机构地区：[1]涡阳县中医院麻醉科,亳州233600 [2]安徽医科大学第二附属医院麻醉与围术期医学科,合肥230601

出　　处：《中国基层医药》2023年第7期1051-1055,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨地佐辛联合舒芬太尼用于剖宫产术后持续硬膜外镇痛的镇痛效果。方法本研究为随机对照试验,取涡阳县中医院2021年2—12月择期行剖宫产产妇86例为研究对象,根据术后镇痛方式不同分为观察组、对照组各43例,观察组采用地佐辛+舒芬太尼+罗哌卡因镇痛,对照组采用地佐辛+罗哌卡因组镇痛。比较两组术后不同时间点(4、8、12、24 h)疼痛视觉模拟评分法(VAS)评分、Ramsay镇静评分、舒适度评分(BCS),观察两组不良反应发生情况。结果观察组术后4、8、12、24 h的VAS评分均显著低于对照组(t=2.34、5.89、15.36、16.23,均P < 0.05);观察组术后4、8、12、24 h的Ramsay镇静评分均高于对照组(t=-6.31、-7.64、-7.49、-7.41,均P < 0.001);观察组术后各时间点舒适度评分均高于对照组(t=-7.60、-10.40、-14.53、-13.80,均P < 0.001);观察组、对照组镇痛泵按压次数分别为(3.00±1.41)次、(7.23±1.31)次,两组差异有统计学意义(t=14.42,P < 0.001);观察组术后24 h内无不良反应发生。结论地佐辛联合使用舒芬太尼硬膜外镇痛,能有效提高剖宫产术后的镇痛效果,安全性良好。Objective To investigate the effects of dezocine combined with sufentanil on continuous epidural analgesia after cesarean section.Methods Eighty-six pregnant women who were scheduled for cesarean section in Guoyang Hospital of Traditional Chinese Medicine from February to December 2021 were included in this randomized controlled study.These women were divided into an observation group and a control group(n=43/group).The women in the observation group underwent epidural analgesia with dizocine,sufentanil,and ropivacaine,while those in the control group underwent epidural analgesia with dizocine and ropivacaine.The visual analogue score,Ramsay sedation score,Bruggrmann comfort scale score,and the incidence of adverse reactions were compared between the two groups.Results At 4,8,12,24 hours after surgery,the visual analogue score(VAS)in the observation group was significantly lower than that in the control group(t=2.34,5.89,15.36,16.23,all P<0.05).At 4,8,12,and 24 hours after surgery,Ramsay sedation score in the observation group was significantly higher than that in the control group(t=-6.31,-7.64,-7.49,-7.41,all P<0.001).At 4,8,12,and 24 hours after surgery,Bruggrmann comfort scale score in the observation group was significantly higher than that in the control group(t=-7.60,-10.40,-14.53,-13.80,all P<0.001).There was a significant difference in the number of effective analgesic pump compressions between the observation and control groups[(3.00±1.41)times vs.(7.23±1.31)times,t=14.42,P<0.001].No adverse reactions were observed in the observation group within 24 hours after surgery.Conclusion Dezocine combined with sufentanil for epidural analgesia can effectively improve the analgesic effects after cesarean section and is highly safe.

关 键 词：剖宫产术 镇痛 硬膜外 麻醉和镇痛 镇痛药 地佐辛 舒芬太尼 疼痛测定 

分 类 号：R614[医药卫生—麻醉学]