哌替啶-氟哌利多防治腰麻下剖宫产术寒战及胃牵拉痛的临床研究

Clinica research of pethidine and droperidor on chills and analgesia stomach-involving undergoing parturient with spinal epidural ansthesia

目的 探讨哌替啶-氟哌利多防治腰麻下行剖宫产术寒战及胃牵拉痛的临床效果.方法 选择腰麻行剖宫产术患者ASAI～Ⅱ 160例,随机平均分成四组,每组40例,胎儿取出后即刻,A组静脉注射哌替啶25 mg和氟哌利多1.25 mg,B组静脉注射哌替啶50 mg和氟哌利多2.5 mg,C组静脉注射哌替啶10 mg和氟哌利多0.5 mg,D组静脉注射0.9%氯化钠2 ml.观察注药时(T0)、注药后5 min(T1)、10 min(T2)、20 min(T3)时平均动脉压(MBP)、血氧饱和度(SpO2)、心率(HR)、呼吸(RR),患者术中术后出现寒战的例数,停止寒战的时间,注药后患者RSS评分,患者术中清理腹腔时胃牵拉痛的VAS评分.结果 A组MBP、SpO2、HR、RR比A、C、D组平稳(P﹤0.05);注药后5min C组5例,D组33例有寒战,明显多于A、B组(P﹤0.01);术中RSS评分,评2～3分,A组例数明显多于其他组(P﹤0.01);A组患者胃牵拉痛的VAS评分明显低于C、D组(P﹤0.01).结论 哌替啶25 mg和氟哌利多1.25 mg合剂是有效防治腰麻下剖宫产术寒战及清理腹腔时胃牵拉痛的最优剂量.

Objective To investigate the clinical effectiveness of pethidine and droperidor on chills and analgesia stomach- involving undergoing parturient with spinal epidural ansthesia. Methods 160 cases of parturient women with shivering(all under combined-spinal epidural anesthesia,ASAI～Ⅱ) were divided randomly into four groups.childbirth immediate: group A ( 40 cases) treated with 25 mg pethedine and 1.25 mg droperidor; group B (40 cases) treated with 50 mg pethedine and 2.5 mg droperidor ;group C (40 cases) treated with 10 mg pethedine and 0.5 mg droperidor;group D treated with 2 ml 0.9% sodium chloride. Observe four groups patients inject drug (T0)、after 5 min inject drug (T1)、10 min(T2)、20 min(T3) MBP、SpO2、HR、RR,the cases with shivering undergoing parturient, the time of shivering arrest,the RSS scores of the patient after inject drug, the VAS scores of the patient analgesia stomach- involving. Results The MBP、SpO2、HR、RR have 22 and 12 cases of on shivering after treatment at 5 min that is more best dose (25 mg pethedine and 1.25 mg droperidor) of the effect of treatment on chills and analgesia stomach- involving undergoing parturient with spinal epidural ansthesia.