小剂量舒芬太尼预防剖宫产术中欣母沛不良反应的临床研究

Small Dose of Sufentanil for Preventing Hamabate Adverse Effects in Cesarean Section

目的:观察舒芬太尼用于防治剖宫产术中卡前列素氨丁三醇(欣母沛)引起不良反应的效果。方法:选择40例需要使用欣母沛的产妇,在连续硬膜外麻醉下行择期剖宫产术,随机分为舒芬太尼组和0.9%氯化钠组。舒芬太尼组在胎儿取出后应用欣母沛的同时,静脉注射舒芬太尼0.1μg/kg;0.9%氯化钠组在胎儿取出后应用欣母沛的同时,静脉注射同等剂量的0.9%氯化钠。监测两组产妇的平均动脉压(MAP)、心率(HR)、脉搏血氧饱和度(SpO_2)、呼吸频率(RR),观察宫体注射欣母沛后产妇恶心、呕吐、胸痛、腹痛、头晕头痛、面部潮红等不良反应,记录麻醉前、使用欣母沛30分钟及术毕的Ramsay镇静评分。结果:使用欣母沛30分钟后舒芬太尼组产妇MAP、HR及RR小于0.9%氯化钠组(P<0.05),Ramsay镇静评分高于0.9%氯化钠组(P<0.05);舒芬太尼组产妇恶心、胸腹痛、头晕头痛、面部潮红等发生率低于0.9%氯化钠组(P<0.05)。结论:小剂量舒芬太尼可减少剖宫产术中欣母沛的不良反应,使循环更加平稳,且有一定的镇静效果,可安全有效用于临床。

Objective：To investigate the effect of sufentanil in preventing the adverse effects of hamabate in the patients undergoing cesarean section. Methods：Forty patients who would have been injected with hamabatewere selected,they were undergoing elective cesarean section with continuous epidural anesthesia and randomly divided into sufentanil group and 0.9% sodium chloride injection group. When the fetus was removed and hama- bate was injected,simultaneously patients in sufentanil group were injected sufentanil 0. 1 μg/ kg,and patients in 0.9% sodium chloride group were injected equal dose of normal saline. MAP, HR,SpO2 and RR were monitored in the two groups. Adverse reactions after hamabate injecting into the body of the uteru, such as nausea,vomi- ting, chest pain, dizziness and facial flushing were recorded, and Ramsay sedation score was recorded before an- esthesia,at 30 min after hamabate was injected and at the ending of the operation. Results：After 30 rain using hamabate, MAP, HR and RR of sufentanil group were more stable than 0.9% sodium chloride group（ P 〈 0. 05）, Ramsay sedation score of sufentanil group was higher than 0.9% sodium chloride group（ P 〈 0. 05）. Adverse re- actions such as nausea, chest pain, dizziness and facial flushing were lower in sufentanil group than those in 0.9% sodium chloride group（ P 〈0. 05）. Conclusions：Small doses of sufentanil can reduce the adverse effects of hamabate in cesarean section,and hemodynamic can be more stable, also it is a certain better sedation,and can be usesd safely.