右美托咪定静脉泵注在腰-硬联合麻醉剖宫产手术中的应用及麻醉效果、安全性评价  

Application of Intravenous Infusion of Dexmedetomidine in Combined Spinal-epidural Anesthesia for Cesarean Section Surgery and Evaluation of Anesthesia Efficacy and Safety

作　　者：陈媛媛 CHEN Yuanyuan(Department of Anesthesiology,Sihong County First People's Hospital,Sihong 223900,China)

机构地区：[1]泗洪县第一人民医院麻醉科,江苏泗洪223900

出　　处：《中国医药指南》2023年第24期57-60,共4页Guide of China Medicine

摘　　要：目的探究分析右美托咪定静脉泵注在腰-硬联合麻醉剖宫产手术中的应用及麻醉效果、安全性评价。方法选取2020年1月至2022年11月于本医院接受剖宫产手术的产妇作为分析研究对象,共106例。根据随机数字表法将剖宫产产妇随机分为对照组与研究组,其中对照组53例,实施盐酸罗哌卡因腰-硬联合麻醉,研究组53例,实施右美托咪定静脉泵注、盐酸罗哌卡因腰-硬联合麻醉。比较分析两组产妇的血流动力学水平、镇静效果、应激反应水平、不良反应发生情况。结果T_(1)时,研究组MAP和HR均低于对照组(P<0.05),T_(2)时,研究组HR低于对照组(P<0.05),研究组产妇在麻醉前,静脉泵注右美托咪定后5min、静脉泵注右美托咪定后30 min、手术结束后的镇静Ramsay评分均高于对照组,组间比较差异显著(P<0.05);麻醉前,两组产妇的各项应激反应指标对比无显著性差异(P>0.05),手术结束后,研究组产妇的皮质醇、丙二醛、血管紧张素Ⅱ指标水平均低于对照组且超氧化物歧化酶高于对照组,对比差异显著(P<0.05);研究组的不良反应发生率低于对照组(P<0.05)。结论右美托咪定静脉泵注辅助腰-硬联合麻醉方法在剖宫产手术中的应用麻醉效果显著,镇静效果良好,可维持血流动力学稳定,能够降低患者应激反应发生风险,安全性可靠,值得应用和推广。Objective To explore and analyze the application of dexmedetomidine intravenous pump injection in combined spinal-epidural anesthesia for cesarean section surgery,as well as to evaluate the anesthesia effect and safety.Method 106 postpartum women who underwent cesarean section surgery in our hospital from January 2020 to November 2022 were selected as the analysis and research subjects.According to the random number table method,cesarean section women were randomly divided into a control group and a study group.Among them,the control group had 53 cases who received ropivacaine hydrochloride combined spinal-epidural anesthesia,while the study group had 53 cases who received dexmedetomidine intravenous infusion and ropivacaine hydrochloride combined spinal-epidural anesthesia.Compare and analyze the hemodynamic levels,sedative effects,stress response levels,and incidence of adverse reactions between two groups of postpartum women.Result At T_(1),the MAP and HR of the study group were lower than those of the control group(P<0.05).while at T_(2),the HR of the study group was lower than that of the control group(P<0.05).The Ramsay scores of sedation in the study group before anesthesia,5 minutes after intravenous infusion of dexmedetomidine,30 minutes after intravenous infusion of dexmedetomidine,and after surgery were all higher than those of the control group,with significant differences between groups(P<0.05).Before anesthesia,there was no significant difference between the two groups in the comparison of various stress response indicators(P>0.05).After the operation,the levels of cortisol,malondialdehyde and angiotensinⅡindicators of the study group were lower than those of the control group,and superoxide dismutase was higher than that of the control group,with significant difference(P<0.05);The incidence of adverse reactions in the study group was lower than that in the control group(P<0.05).Conclusion The application of dexmedetomidine intravenous pump assisted spinal-epidural anesthesia method in cesarean se

关 键 词：右美托咪定 腰-硬联合麻醉 应激反应 麻醉镇静效果 不良反应 剖宫产 

分 类 号：R614[医药卫生—麻醉学] R719.8[医药卫生—外科学]