盐酸右美托咪定与酒石酸布托啡诺对剖宫产术中寒颤反应的防治效果分析

Effects of Dexmedetomidine and Butorphanol on prevention and treatment of shivering during cesarean delivery

目的观察盐酸右美托咪定与酒石酸布托啡诺防治剖宫产术中寒颤反应的效果。方法2019年7月~9月于郑州大学第三附属医院60例择期在腰硬联合麻醉下行剖宫产手术的产妇,足月妊娠,无妊娠期并发症,无椎管内麻醉禁忌证,按麻醉用药的不同分为盐酸右美托咪定组(D组)和酒石酸布托啡诺组(B组),每组30例。胎儿娩出即刻静脉给药,D组微量注射泵静脉泵注右美托咪定负荷量1μg/kg,输注时间10 min,继以0.5μg/(kg·h)持续输注,至关腹完毕后停药。B组给予酒石酸布托啡诺2 mg。记录静脉给药后15 min产妇的寒颤分级及不良反应发生情况。结果与B组相比,D组寒颤发生率明显降低(P<0.05),寒颤程度明显减轻(P<0.05),恶心呕吐发生率明显降低(P<0.05)。两组产妇Ramsay评分、心动过缓、低血压等不良反应发生率差异无统计学意义。两组产妇围术期无呼吸抑制发生。结论盐酸右美托咪定防治剖宫产术中寒颤反应的效果优于酒石酸布托啡诺。

Objective To evaluate the effects of dexmedetomidine and butorphanol on the prevention and treatment of shivering during cesarean delivery.Methods Sixty full-term parturients scheduled for cesarean delivery under combined spinal and epidural anesthesia,with no pregnancy complications or intravertebral anesthesia contraindications were randomly divided into two groups according to the different narcotic drugs:dexmedetomidine group(group D)and butorphanol group(group B),30 cases in each group.After the delivery of the baby,the parturients in group D received an intravenous infusion loading dose of 1μg/kg of dexmedetomidine within 10 minutes,and following with an intravenous infusion 0.5μg/(kg·h)of dexmedetomidine until peritoneal closure.While the parturients in group B received butorphanol 2 mg intravenously.The incidence and degree of shivering were recorded 15 min after intravenous administration.And the occurrence of adverse reactions were recorded.Results Compared with group B,the incidence and degree of shivering in group D were significantly lower(P<0.05).And the incidence of nausea and vomiting in group D was significantly lower(P<0.05)than that in group B.There were no significant differences in the incidence of Ramsay score,bradycardia,hypotension and other adverse reactions between the two groups.No respiratory depression occurred during perioperative period in the two groups.Conclusion Dexmedetomidine is more effective than butorphanol in the prevention and treatment of shivering during cesarean delivery.