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小剂量氯胺酮联合布托啡诺防治剖宫产术中胃牵拉痛和寒战的临床观察 被引量:5

THE EFFECTS OF A SMALL DOSE OF KETAMINE COMBINED BUTORPHANOL ON THE STOMACH DRAGGING PAIN AND CHILLS OF PATIENTS UNDERGOING CESAREAN SECTION
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摘要 目的观察氯胺酮联合布托啡诺防治硬膜外麻醉下剖宫产术中胃牵拉痛和寒战的临床效果。方法120例硬膜外麻醉下接受剖宫产术产妇,分为对照组和观察组,各60例,观察组为硬膜外阻滞手术开始前静脉给予0.4mg/kg氯胺酮,胎儿娩出即刻,静滴布托啡诺15μg/kg,对照组不用任何镇痛镇静药物,观察术中产妇生命体征的变化,胎儿娩出及探查关腹时胃牵拉痛的VAS评分,RSS镇静评分和出现Wrench寒战分级的情况。结果胎儿娩出及探查关腹时,观察组与对照组比较血压,心率差异有统计学意义(P<0.05);观察组产妇在胎儿娩出及探查关腹时VAS评分明显均低于对照组(P<0.05);观察组产妇RSS镇静评分与对照组比较差异有统计学意义(P<0.05),观察组产妇术中Wrench寒战分级与对照组比较差异有统计学意义(P<0.05)。二组恶心、呕吐、呼吸抑制比较差异均无统计学意义(P均>0.05)。结论小剂量氯胺酮联合布托啡诺应用于硬膜外剖宫产术中防治胃牵拉痛和寒战效果明显,患者术中生命体征平稳,舒适度提高。 Objective To observe the effects of a small dose of ketamine combined butorphanol on the stom- ach dragging pain and chills of patients undergoing cesarean section. Methods One hundred and twenty women who received cesarean section under epidural anesthesia were randomnly divided into control group and experimental group. The patients in experimental group were given 0.4 mg/kg ketamine before the start of operation and injected butorphanol 15 tzg/kg after fetal childbirth instantly, while patients in con- trol group were not given any analgesia and sedative drugs. The changes of intraoperative vital signs of ma- ternal, stomach pull pain VAS score, RSS sedation scores and a Wrench chills classification were observed at fetal childbirth and probe closed abdomen. Results Fetal childbirth and probe closed abdomen: the blood pressure and heart rate in experimental group were lower than those in control group (P〈0.05) VAS score in the experimental group was significantly lower than that in control group at maternal fetal childbirth and closed abdominal (P〈0.05) RSS sedation score in experimental group was significantly higher than that in control group (P〈0.05). The Wrench chills classification in the experimental group was significantly lower than that in control group (P〈0.05). There were no statistically significant differ- ence in nausea, vomiting, respiratory depression (P〈0.05). Conclusion A small dose of ketamine com- bine with butorphanol has the effect of prevention and treatment of stomach dragging pain and chills of pa- tients undergoing epidural anaesthesia and cesarean section.
作者 王蕾 夏中元
出处 《中国煤炭工业医学杂志》 2014年第7期1042-1044,共3页 Chinese Journal of Coal Industry Medicine
关键词 氯胺酮 布托啡诺 剖宫产 胃牵拉痛 寒战 硬膜外麻醉 Ketarnine Butorphanol Cesarean section Stomach dragging pain Chills Epidural anaesthesia
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