鞘内注射三种阿片类药复合调整剂量布比卡因用于剖宫产的对比研究  

Comparative study of intrathecal injection of three opioid drugs with compound adjusted dose bupivacaine for cesarean section

作　　者：朱云峰 Zhu Yunfeng(Department of Anesthesiology,Guangxi-ASEAN Economic and Technological Development Zone People's Hospital(Nanning 10th People's Hospital),Nanning 530105,China)

机构地区：[1]广西-东盟经济技术开发区人民医院(南宁市第十人民医院)麻醉科,广西南宁530105

出　　处：《实用妇科内分泌电子杂志》2024年第3期83-86,共4页Electronic Journal of Practical Gynecological Endocrinology

摘　　要：目的对比3种阿片类药物联合调整剂量的布比卡因等比重液为脊麻药行剖宫产,评估围手术期麻醉及不良反应等方面的效果。方法选取90例单胎足月妊娠接受择期或急诊剖宫产手术患者,按照随机数字表法分为M组(n=28)、F组(n=30)和S组(n=29),分别注射吗啡200μg、芬太尼16μg和舒芬太尼2μg,根据产妇身高和体质量调整0.5%布比卡因的剂量行脊麻。观察术中麻醉效果和不良反应,并进行统计学分析。结果收集有效研究样本87例。S组感觉阻滞平面达T_(6)水平的时间短于F组、M组,M组的完全镇痛时间和有效镇痛时间均长于S组和F组,差异有统计学意义(P<0.05)。M组的肌松评级R值大于3组评级均值,差异有统计学意义(P<0.05)。M组产妇恶心发生率高于F组和S组,差异有统计学意义(P<0.05)。结论鞘内注射3种阿片类药复合调整剂量的布比卡因用于剖宫产,在围手术期均能提供满意的麻醉效果,新生儿不良反应少。考虑到较慢的起效时间以及未知的迟发性术后并发症等因素,鞘内注射舒芬太尼更可取。Objective Compare the effects of three opioid drugs combined with adjusted doses of bupivacaine as a spinal anesthetic for cesarean section,and evaluate the perioperative anesthesia and adverse reactions.Methods 90 patients of single full-term pregnancy who underwent elective or emergency cesarean section surgery were selected and randomly divided into M group(n=28),F group(n=30),and S group(n=29)using a random number table method.Morphine 200,Fentanyl 16μg and sufentanil 2ug was injected into each group.Adjust the dosage of 0.5%bupivacaine for spinal anesthesia according to the height and body weight of the mother.Observe the anesthesia effect and adverse reactions during surgery,and conduct statistical analysis.Results Collect 87 valid research samples.The time for the S group to reach the T_(6) level of sensory blockade was shorter than that of the F and M groups,and the complete and effective pain relief time of the M group was longer than that of the S and F groups,with statistical significance(P<0.05).The R value of muscle relaxation rating in Group M was greater than the mean rating of Group 3,and the difference was statistically significant(P<0.05).The incidence of nausea in group M was higher than that in groups F and S,and the difference was statistically significant(P<o.05).Conclusion Intrathecal injection of three opioid drugs combined with adjusted dose bupivacaine for cesarean section can provide satisfactory anesthesia effects during the perioperative period,with fewer adverse reactions in newborns.Considering factors such as slower onset time and unknown delayed postoperative complications,intrathecal injection of sufentanil is more advisable.

关 键 词：吗啡 芬太尼 舒芬太尼 脊麻 布比卡因 

分 类 号：R614[医药卫生—麻醉学]