盐酸右美托咪啶和地佐辛治疗腰硬联合麻醉剖宫产产妇寒颤效果比较

Comparison of dexmedetomidine with dezocne in prevention of shiver for parturients with cesarean delivery under CSEA

目的比较盐酸右美托咪啶和地佐辛治疗腰硬联合麻醉剖宫产产妇寒颤的效果及伴随的不良反应。方法选择拟行腰硬联合麻醉剖宫产手术的产妇120例,足月妊娠且无妊娠期并发症,无椎管内麻醉禁忌证。采用随机数字表法分为盐酸右美托咪啶组和地佐辛组,各60例。胎儿娩出即刻静脉给药,盐酸右美托咪啶组给予盐酸右美托咪啶0.4μg/kg,地佐辛组给予地佐辛0.15mg/kg。记录患者寒颤的分级情况及不良反应发生情况。结果两组产妇治疗前后各级寒颤发生率的差异均无统计学意义(均P>0.05),治疗后两组均未发生3级及4级寒颤。盐酸右美托咪啶组眩晕、恶心、呕吐及胸闷等不良反应发生率均低于地佐辛组(均P<0.05),且盐酸右美托咪啶组在睡眠状态下可唤醒患者数高于地佐辛组(P<0.05)。结论地佐辛与盐酸右美托咪啶均能有效治疗腰硬联合麻醉剖宫产产妇的寒颤,但地佐辛不良反应的发生率高于盐酸右美托咪啶。

Objective To compare the preventive effect on shiver between dexmedetomidine and Dezocne in parturi-ents with cesarean delivery under combined spinal and extradural anesthesia （CSEA）. Methods One hundred and twenty par-turients with ful- term pregnancy, no pregnancy complications, no contraindication for intra- spinal canal anesthesia were scheduled for cesarean delivery under CSEA. Parturients were randomly divided into 2 groups （n=60 in each）：after fetal child-birth, group DEX received intravenous dexmedetomidine 0.4μg/kg and group Dez received dezocne 0.15mg/kg. The classifi-cation of shiver and adverse reactions were documented. Results There was no significant difference in incidence of shiver grades 1 and 2 between two groups （P 〉0.05）, and no shiver of grades 3 and 4 occurred in both groups. The incidence of dizziness, nausea, vomiting, respiratory depression, and lethargy in group DEX was significantly lower than that in group Dez （P〈0.05）; and parturients in group DEX were more likely to be awoken from the sleep state （P〈0.05）. Conclusion Both dexmedetomidine and dezocne can effectively prevent shiver in parturients with cesarean delivery under CSEA, but dezocre has higher incidence of adverse reactions than dexmedetomidine.