舒芬太尼联合右美托咪定对30例急诊剖宫产麻醉效果的影响

The anesthesia effects of sufentanil combined with dexmedetomidine on 30 cases of puerperae with emergency caesarean section

目的:观察舒芬太尼联合右美托咪定在急诊剖宫产中对产妇麻醉效果的影响。方法:硬膜外麻醉下行急诊剖宫产产妇120例,随机分为4组,每组30例。所有产妇均先给予0.75%罗哌卡因15 ml,然后B组再静脉给予舒芬太尼10μg、C组静脉15 min内泵入右美托咪定0.5μg/kg、D组静脉给予舒芬太尼10μg联合静脉15 min内泵入右美托咪定0.5μg/kg。术中连续监测产妇循环呼吸状况,观察不良反应和新生儿的情况。结果:B组、D组胎儿取出前镇痛效果优于A组(P<0.05);C组、D组焦虑评分低于A组(P<0.05);C组、D组生命体征波动小于A组,且恶心、呕吐、低血压、寒战发生率低于A组(P<0.05)。结论:在急诊剖宫产硬膜外麻醉中舒芬太尼和右美托咪定静脉联合给药能够增强胎儿取出前镇痛效果,抑制牵拉反应,减少生命体征波动,降低恶心呕吐、低血压、寒战发生率。

Objective： To investigate the anesthesia effects of sufentanil and dexmedetomidine on puerperae undergoing emergency cesarean section. Methods： One hundred and twenty cases of puerperae were randomly divided into four groups with 30 cases each. All the puerperae were first epidurally injected with 0.75% ropivacaine 15 ml, then group B was intravenously given 10 μg of sufentanil, group C was intravenously pumped 0.5μg/kg of dexmedetomidine within 15 min while group D was given 10 μg of sufentanil combined with 0.5 μg/kg ofdexmedetomidine within 15 min. During operations, their circulatory and respiratory conditions were continuously monitored, while the adverse reactions occurred in these women and newborns were observed. Results： The anesthesia effects were better in group B and D than group A. The anxiety scores were lower in group C and D than group A. The fluctuation in vital signs was less in group C and D than in group A. The incidence of nausea, vomiting, hypotension, chill was lower in group C and D than in group A. Canelusion： In the epidural anesthesia of emergency cesarean section, intravenous co-administration of sufentanil and dexmedetomidine can enhance analgesic effects before delivery of baby, inhibit draw reaction, decrease the fluctuation in vital signs and reduce the incidence of adverse reactions such as nausea, vomiting, hypotension and chill.