曲马多配伍氟哌利多辅助剖宫产腰硬联合麻醉的临床观察

Clinical Observation of Tramadol Compatibility Droperidol Auxiliary Cesarean Section Combined Spinal Epidural Anaesthesia

目的探讨曲马多配伍氟哌利多辅助剖宫产腰硬联合麻醉的效果。方法选择150例首次剖宫产产妇,随机分为三组,各50例,腰硬联合麻醉下取出胎儿后,分别静脉推入生理盐水(Ⅰ组);氟哌利多1.25mg,芬太尼0.05mg(Ⅱ组);氟哌利多1.25mg,曲马多75～100mg(Ⅲ组)。观察三组MAP、HR、SpO2用药前和用药后10min的变化,用药后牵拉疼痛、寒战、恶心呕吐的发生例数。结果Ⅰ组用药后10minHR、MAP较用药前明显增高(P<0.05),同Ⅱ、Ⅲ组同时间比较也有显著差异(P<0.05)。Ⅰ组牵拉反应、寒战、恶心呕吐发生率均远高于Ⅲ组(P<0.05),Ⅱ组牵拉反应和恶心呕吐发生率和Ⅲ组相似,但寒战率明显高于Ⅲ组(P<0.05)。结论曲马多配伍氟哌利多应用于剖宫产腰硬联合麻醉具有对抗牵拉疼痛,避免恶心呕吐,预防和控制寒战的作用。

Objective To investigate tramadol compatibility droperidol auxiliary cesarean section combined spinal epidural anesthesia effect.Methods A total of 150 patients with first cesarean section maternity,randomly divided into three groups,each fifty cases,combined spinal epidural anesthesia,remove the fetus were intravenous push physiological saline（Ⅰ group）;Droperidol 1.25 mg,fentanyl 0.05 mg（Ⅱ group）;Droperidol 1.25 mg,tramadol 75-100 mg（Ⅲ group）.Three groups of observation MAP,HR,SpO2 medication before and after ten minutes of the change,after guyed pain,nausea and vomiting,chill the happening of the number.The Results Ⅰ group after 10 minhr,MAP more drugs significantly higher before（P〈0.05）,with Ⅱ,Ⅲ group compared with time also had significant difference（P〈0.05）.Ⅰ group of guyed reaction,chill,incidence of nausea and vomiting are far higher than Ⅲ group（P〈0.05）,Ⅱ group of guyed reaction and incidence of nausea and vomiting and Ⅲ group similar,but chill rate is obviously higher than that of the Ⅲ group（P〈0.05）.Conclusion Tramadol compatibility droperidol applied in cesarean section combined spinal epidural anesthesia has against the pull pain,avoid nausea and vomiting,prevent and control the role of chill.