静脉泵注小剂量瑞芬太尼对瘢痕子宫产妇剖宫产手术中舒适度的影响  

Effect of intravenous injection of remifentanil on comfort level of birth-giving women with scarred uterus undergoing cesarean section

作　　者：吴磊[1] 田振 田宇峰 陈悦[1] 严志勇 杜鹃 WU Lei;TIAN Zhen;TIAN Yu-feng;CHEN Yue;YAN Zhi-yong;DU Juan(Department of Anesthesia and Perioperative Medicine,Suqian Hospital of Jiangsu Provincial People's Hospital,Suqian Jiangsu 223800,China;Department of Anesthesia,Nanjing Drum Tower Hospital Group Suqian Hospital,Suqian Jiangsu 223800,China;Department of Gynaecology and Obstetrics,Suqian Hospital of Jiangsu Provincial People's Hospital,Suqian Jiangsu 223800,China)

机构地区：[1]江苏省人民医院宿迁医院麻醉与围术期医学科,江苏宿迁223800 [2]南京鼓楼医院集团宿迁医院麻醉科,江苏宿迁223800 [3]江苏省人民医院宿迁医院妇产科,江苏宿迁223800

出　　处：《局解手术学杂志》2025年第3期232-235,共4页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的探讨静脉泵注小剂量瑞芬太尼对瘢痕子宫产妇剖宫产手术中舒适度的影响。方法选取2021年10月至2023年9月在江苏省人民医院宿迁医院行剖宫产手术的瘢痕子宫产妇82例为研究对象,随机分为对照组和观察组(每组41例)。在剖宫产切皮前,观察组产妇静脉泵注0.05μg·kg-1·min-1瑞芬太尼至手术结束,对照组产妇静脉泵注等量生理盐水。对2组产妇不同时点的生命体征和疼痛情况、牵拉反应及母婴并发症发生情况进行比较。结果在腹腔探查时,观察组产妇的平均动脉压(MAP)、心率(HR)、疼痛视觉模拟量表(VAS)评分、牵拉反应发生率均明显低于对照组(P<0.05)。2组在新生儿脐静脉血pH值、脐静脉血脉搏血氧饱和度(SPO2)、出生1 min和5 min的Apgar评分、产妇恶心呕吐和呼吸抑制等方面差异均无统计学意义(P>0.05)。结论对于瘢痕子宫剖宫产产妇,静脉泵注0.05μg·kg-1·min-1瑞芬太尼可以减少其生命体征的波动,显著减轻术中探查时牵拉刺激,母婴并发症少,有利于提高产妇的舒适度。Objective To investigate the effect of intravenous injection of remifentanil on the comfort level of birth-giving women with scarred uterus undergoing cesarean section.Methods A total of 82 birth-giving women with scarred uterus who underwent cesarean section in the Suqian Hospital of Jiangsu Provincial People's Hospital from October 2021 to September 2023 were selected and randomly divided into the observation group and the control group(with 41 cases in each group).Before skin resection of cesarean section,the birth-giving women of the observation group were injected with 0.05μg·kg-1·min-1 remifentanil intravenously until the end of the operation,and these in the control group was injected with the same amount of normal saline.The vital signs and pain at different time points,traction reaction and occurrence of maternal and infant complications were compared between the two groups.Results The mean arterial pressure(MAP),heart rate(HR),pain visual analogue scale(VAS)score and incidence of traction reactions at abdominal exploration in the observation group were significantly lower than those in the control group(P<0.05).There was no significant difference in the neonatal umbilical vein pH value,umbilical vein blood pulse oximetry saturation(SPO2),Apgar scores 1 minute and 5 minutes after birth of newborn,or nausea,vomiting and respiratory depression of birth-giving women between the two groups(P>0.05).Conclusion For birth-giving women with scar uterus who underwent cesarean section,intravenous injection of 0.05μg·kg-1·min-1 of reifentanil can reduce the fluctuation of vital signs,significantly relieve the traction reaction at abdominal exploration,with a few maternal and infant complications,which is conducive to improving the comfort level of the birth-giving women.

关 键 词：瑞芬太尼 腰麻 瘢痕子宫 剖宫产 新生儿 术中舒适度 

分 类 号：R714[医药卫生—妇产科学]