右美托咪定联合喷他佐辛预防剖宫产麻醉中寒战与牵拉痛的应用研究  

Study on the application of dexmedetomidine combined with pentazocine in prevention of shivering and traction pain during cesarean section anesthesia

作　　者：麻志敏 张媛 方建勤 曾水和 蒋爱华 MAZhimin;ZHANG Yuan;FANG Jianqin;ZENG Shuihe;JIANG Aihua(Department of Anesthesiology,Luohu Maternal and Child Health Hospital,Shenzhen,Guangdong,518000,China)

机构地区：[1]罗湖区妇幼保健院麻醉科,广东深圳518000

出　　处：《当代医学》2023年第21期73-76,共4页Contemporary Medicine

摘　　要：目的探究右美托咪定联合喷他佐辛对剖宫产术中寒战及牵拉痛的预防效果。方法选取2020年8月至2021年5月于本院行剖宫产的60名产妇作为研究对象,采用随机数字表法分为两组,每组30名。对照组于胎儿娩出断脐后,静脉泵入芬太尼联合右美托咪定;观察组于胎儿娩出断脐后,静脉泵入右美托咪定联合喷他佐辛。比较两组术后不同时间镇痛评分、镇静评分及术中牵拉痛、寒战发生率。结果两组Pamsay评分时间比较差异有统计学意义(P<0.05);两组Pamsay评分组间、交互比较差异均无统计学意义。组内比较:探查时,两组Pamsay评分均低于术前、给药时、术毕,术前、术毕时均低于给药时,差异有统计学意义(P<0.05),而术毕与术前比较差异无统计学意义。组间比较:术前、给药时、术毕,两组Pamsay评分比较差异均无统计学意义;探查时,观察组Pamsay评分高于对照组,差异有统计学意义(P<0.05)。两组视觉模拟评分法(VAS)评分时间、交互比较差异无统计学意义;两组VAS评分组间比较差异有统计学意义(P<0.05)。组内比较:观察组术后各时间点VAS评分两两比较差异均无统计学意义;术后24、48 h,对照组VAS评分均低于术后2 h,术后48 h低于术后12 h,差异有统计学意义(P<0.05),其他各时间点两两比较差异无统计学意义。组间比较:术后2、12、24、48 h,观察组VAS评分均低于对照组,差异有统计学意义(P<0.05)。观察组术中牵拉痛发生率为16.67%,明显低于对照组的50.00%,差异有统计学意义(P<0.05)。观察组寒颤发生率为16.67%,低于对照组的43.33%,差异有统计学意义(P<0.05)。结论右美托咪定联合喷他佐辛用于剖宫产麻醉中,不仅具有良好镇痛镇静效果,还可有效预防术中寒战及牵拉痛的发生,且安全性较高。Objective To explore the preventive effect of dexmedetomidine combined with pentazocine on shivering and traction pain during cesarean section.Methods 60 parturients who underwent cesarean section in our hospital from August 2020 to May 2021 were selected as the research subjects,and they were divided into the two groups according to the random number table method,with 30 cases in each group.The control group received intravenous infusion of fentanyl combined with dexmedetomidine after the fetus delivered the umbilical cord was broken,while the observation group received intravenous infusion of dexmedetomidine combined with pentazocine after the fetus delivered the umbilical cord was broken.The postoperative analgesia scores,sedation scores at different times after operation,the incidence of intraoperative traction pain and chills were compared between the two groups.Results There was statistical difference in Pamsay score of time points between the two groups(P<0.05);there were no statistical differences in Pamsay score between the two groups of group and interaction.Comparison within group:at exploration,the Pamsay score of the two groups was lower than before operation,at administration and after operation,and before and after operation were lower than at administration,the differences were statistically significant(P<0.05),but there was no statistically significant difference in Pamsay score between after operation and before operation.Comparison between groups:before operation,at the time of administration and after operation,there were no significant differences in Pamsay scores between the two groups;at exploration,the Pamsay score in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in visual analogue scale(VAS)score of time points and and interaction between the two groups;there was statistically significant difference in VAS scores of group between the two groups(P<0.05).Comparison within group:the

关 键 词：右美托咪定 喷他佐辛 剖宫产 寒战 牵拉痛 

分 类 号：R614[医药卫生—麻醉学]