鞘内注射右美托咪定对轻度子痫前期剖宫产产妇麻醉镇静效果及新生儿影响  

Analgesic and sedate effect of intrathecal injection of dexmedetomidine during cesarean section of women with mild preeclampsia and its influence on their neonates

作　　者：陈德丹 吴坤雷 许业敏 王淑萍 黄学[1] CHEN Dedan;WU Kunlei;XU Yemin;WANG Shuping;HUANG Xue(Qionghai Hospital of Traditional Chinese Medicine,Qionghai,Hainan Province,571400)

机构地区：[1]海南省琼海市中医院,571400

出　　处：《中国计划生育学杂志》2023年第8期1849-1852,1857,共5页Chinese Journal of Family Planning

基　　金：海南省卫生健康行业科研项目(20A200288)。

摘　　要：目的:探究鞘内注射右美托咪定对轻度子痫前期剖宫产产妇的麻醉镇静效果及新生儿影响。方法:选取2019年6月-2021年6月本院收治的轻度子痫前期剖宫产产妇105例临床资料,根据资料中麻醉药物使用分为对照组(基础麻醉药物,n=51)和观察组(基础麻醉药物联合鞘内注射右美托咪定,n=54)。对比两组麻醉效果(感觉阻滞、运动阻滞Bromage评分)、镇静效果(切皮时、取出胎儿时、术毕时的PASS评分)、不良反应及新生儿体重、Apgar评分、神经评分(NBNA)评分。结果:观察组感觉阻滞、运动阻滞的起效时间较对照组短,感觉阻滞、运动阻滞的持续时间较对照组长,两组PASS评分在切皮后均呈先升后降趋势,且观察组切皮时(0.68±0.17分)、取出胎儿时(1.14±0.34分)、术毕时(0.56±0.19分)均低于对照组(0.82±0.20分、1.55±0.38分、0.73±0.21分)(均P<0.05)。两组不良反应(27.8%、25.5%)、新生儿出生时体重、新生儿出生1h、24h的NBNA评分、新生儿出生1min及5min Apgar评分均无差异(P>0.05)。结论:轻度子痫前期剖宫产产妇采取0.75%罗哌卡因复合鞘内注射右美托咪定,可提高麻醉效果和镇痛效果,安全性尚可,对新生儿影响较小。Objective:To study the efetst of intrathecal ijection of dexmedetomidine during cesarean section of women with mild preclampsia on their anesthesia,PASS score,and neonates.Methods:The clinical data of 105 women with mild preeclampsia after cesarean section from June 2019 to June 2021 were selected in the study.According to the an-aesthetie drugs used.these women were included 51 with basic anesthetics in control group,and 54 women with basic anesthetics combined with dexmedetomidine intrathecal injection in study group.The anesthesia efect(sensory block and motor block Bromage score),the sedation effect(PASS score at the time of skin incision,at the fetus delivery,and at the end of the operation),and the adverse reactions rate of the women,and the neonatal birth weight,Apgar score,and behavioral neurological assessment(NBNA)score were compared between the two groups.Results:The onset time of sensory block or motor block of the women in the study group was significantly shorter than that of the women in the control group,and the duration of sensory block or motor block of the women in the study group was significantly longer than that of the women in the control group.The PASS scores of the women in both groups had in-creased firstly,and then had decreased after skin incision,and which of the women in the study group at the skin inci-sion(0.68±0.17 points),at the fetus delivery(1.14±0.34 points),and at the end of the operation(0.56±0.19 points)were significantly lower than those(0.82±0.20 points,1.55±0.38 points,and 0.73±0.21 points)of the women in the control group(all P<0.05).There were no significant differences in adverse reactions rate(27.8%vs.25.5%)of the women,and the neonatal birth weight,NBNA scores at 1h and 24h after born,and Apgar scores at 1min and 5min after born between the two groups(P>0.05).Conclusion:0.75%ropivacaine combined with intrathe-cal injection of dexmedetomidine during cesarean section of the women with mild preeclampsia can effectively improve their anesthesic and analgesic efect

关 键 词：轻度子痫前期 剖宫产 鞘内注射右美托咪定 镇静效果 新生儿 

分 类 号：R614[医药卫生—麻醉学]