布托啡诺超前镇痛用于剖宫产手术的临床观察

目的观察布托啡诺超前镇痛用于剖宫产手术对麻醉操作和取胎的镇痛评分(VAS评分)、镇静评分(MS)以及新生儿apger评分的影响。方法选择80例ASAⅠ～Ⅱ级的择期剖宫产患者,随机分成两组(n=40),每组都由同一人进行麻醉操作,采用同样的麻醉药和给药方法,麻醉平面控制在(T6～T8)～S。A组在麻醉操作前5min给予布托啡诺1mg加生理盐水稀释到5ml两分钟内缓慢静脉注射。B组在麻醉操作前5min给予生理盐水5ml两分钟内缓慢注射。记录静脉给药前后5min的血压、心率,给药后的镇静评分(RS),麻醉操作和取胎时的疼痛评分(VAS),新生儿的Apgar评分以及不良反应发生率。结果 A组静脉给药前后血压、心率比较差异无显著性意义(P>0.05);两组RS评分比较差异有显著性意义(P<0.05);两组的麻醉操作VAS评分A组低于B组,经比较差异无显著性意义(P>0.05);两组取胎时的VAS评分比较差异有显著性意义(P<0.05);两组的新生儿Apgar评分比较差异无显著性意义(P>0.05)。两组均无呼吸抑制发生,恶心呕吐的发生率比较差异无显著性意义(P>0.05)结论布托啡诺超前镇痛用于剖宫产手术效果确切,对血流动力学无影响,对新生儿Apgar评分无影响,能减轻患者麻醉操作和取胎操作时的不适感,且有明显的镇静作用,不良反应发生率低,值得临床应用。

Objective Butorphanol for advance of anesthesia analgesia cesarean delivery operation of analgesia womb operations and take VAS rating scale, calm score （MS） and the influence of neonatal apger score. Methods selection Ⅰ - 80 cases of Ⅱ level ASA elective cesarean section patients, divided into two groups at random （n = 40）, each of anesthesia by the same people in the same operation, anesthetics and dosing method, anesthesia plane control in （T6 - T8） -S. Group A before operation in anesthesia 5min give Butorphanol lmg add saline diluted 5ml two minutes to slow intravenous. Group B before operation in anesthesia 5min give saline 5ml two minutes slow injection. Record before and for medicine for intravenous drugs of blood pressure and heart rate, 5min after the administration calm score （RS）, anesthesia operation and take child pain score （VAS）, neonatal Apgar score, and ＇adverse reaction rate. Results before and after the group A vein to medicine blood pressure and heart rate comparative differences no significant （P〉0.05）. Two groups of RS score comparative differences have significant （P〈 0.05）. Two groups of anesthesia operation VAS score below group A group B, but no significant comparative differences （P〉0.05）. Two groups of take child VAS score comparative differences have significant（P〈0.05）. Two groups of neonatal Apgar score comparative differences no significant （P〉0.05）. Both groups without respiratory depression occurs, the incidence of nausea and vomiting no significant comparative differences （P〉0.05）. Conclusion Butorphanol for advance analgesia operation effect of cesarean delivery, exactly, without influence of hemodynamic Apgar score no effect on the newborn, relieve patients anesthesia operation and take the womb operation, and has obvious discomfort the sedative function, and adverse reaction rate low, worth clinical use.