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探讨  

Application of intravenously administered dexmedetomidine in combined spinal-epidural anesthesia for cesarean section

作　　者：钟宗仁 毕生龙 李帆 杨瑜 ZHONG Zong-ren;BI Sheng-long;LI Fan(Anesthesiology Department,Ganzhou Maternal and Child Health Hospital,Ganzhou 341000,China)

机构地区：[1]赣州市妇幼保健院麻醉科,341000

出　　处：《中国现代药物应用》2024年第11期18-22,共5页Chinese Journal of Modern Drug Application

摘　　要：目的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价值,旨在为相关研究工作提供参考依据。方法选择接受腰-硬联合麻醉下剖宫产手术的产妇72例为研究样本,结合产妇术中是否应用右美托咪定分为新式组(36例)、传统组(36例)。传统组产妇术中不应用镇静镇痛药物,新式组产妇术中应用右美托咪定。对比两组产妇各阶段[麻醉前(T0)、麻醉药注射完毕后10 min(T1)、麻醉药注射完毕后30 min(T2)]心率、平均动脉压(MAP)水平,麻醉镇痛效果,新生儿Apgar评分。结果T0时,两组产妇MAP以及心率对比无明显差异(P>0.05);T1和T2时,传统组的MAP和心率较T0时显著上升(P<0.05);新式组T1以及T2时的MAP和心率比T0时有波动,但无明显差异(P>0.05)。和传统组相比,新式组T1以及T2时的MAP以及心率更低(P<0.05)。新式组麻醉镇痛总有效率为100.00%,比传统组的88.89%高(P<0.05)。新式组新生儿出生后1、5、10 min的Apgar评分分别为(9.55±0.66)、(9.77±0.18)、(9.98±0.03)分,传统组分别为(8.36±0.72)、(8.88±0.42)、(9.18±0.29)分。两组新生儿出生后1、5、10 min的Apgar评分对比,新式组高于传统组(P<0.05)。结论对于接受腰-硬联合麻醉剖宫产手术的产妇而言,术中为其应用右美托咪定能取得满意的镇痛效果,且该用药方案对于产妇的MAP、心率影响较小,有助于改善产妇的围术期舒适度,并且对于新生儿不存在显著影响,安全性强,值得进一步在产科临床内推广和应用。Objective To analyze the application value of intravenously administered dexmedetomidine in combined spinal-epidural anesthesia for cesarean section,and provide reference for related research work.Methods A total of 72 women receiving combined spinal-epidural anesthesia for cesarean section were selected as the study samples,and the subjects were divided into the new group(36 cases)and the traditional group(36 cases)according to whether dexmedetomidine was used during the operation.Subjects in the traditional group did not apply sedative and analgesic drugs intraoperatively,and subjects in the new group applied dexmedetomidine intraoperatively.The heart rate and mean arterial pressure(MAP)at each stage[before anesthesia(T0),10 min after anesthetic injection(T1)and 30 min after anesthetic injection(T2)],analgesic effect and neonatal Apgar score of the two groups were compared.Results At T0,there were no significant differences in MAP and heart rate between the two groups(P>0.05).MAP and heart rate at T1 and T2 were significantly increased compared with those at T0 of the traditional group(P<0.05).MAP and heart rate of the new group at T1 and T2 showed fluctuations compared with those at T0,but there was no significant difference(P>0.05).Compared with the traditional group,MAP and heart rate were lower in the new group at T1 and T2(P<0.05).The total effective rate of anesthesia and analgesia in the new group was 100.00%,which was higher than 88.89%in the traditional group(P<0.05).The Apgar scores at 1,5 and 10 min after birth in the new group were(9.55±0.66),(9.77±0.18)and(9.98±0.03)points,while those in the traditional group were(8.36±0.72),(8.88±0.42)and(9.18±0.29)points.The Apgar scores at 1,5 and 10 min after birth in the new group were higher than those in the traditional group(P<0.05).Conclusion For women undergoing combined spinal-epidural anesthesia for cesarean section,the intraoperative application of dexmedetomidine can achieve satisfactory analgesic effects,and this medication regimen has little i

关 键 词：右美托咪定 静脉泵注 腰-硬联合麻醉 剖宫产手术 应用价值 

分 类 号：R614[医药卫生—麻醉学]