小剂量舒芬太尼预防剖宫产术中寒战和牵拉疼痛的效果观察

Observation of the effect of low-dose sufentanil as anesthetic in chills and traumatic pain during cesarean section

目的探讨小剂量舒芬太尼作为麻醉剂应用于剖宫产术中防寒战和牵拉疼痛的效果。方法选取广饶县人民医院妇产科接收的剖宫产产妇92例,将产妇采用随机数字表法均分为两组,均行腰硬联合阻滞麻醉。观察组采用舒芬太尼(5μg)+0.75%罗哌卡因(1.5 m L)+10%葡萄糖(2.5 m L);对照组采用0.75%罗哌卡因(1.5 m L)+10%葡萄糖(2.5 m L)。统计记录两组产妇手术前、注药1、3、5、10 min以及手术结束产妇平均动脉压及心率水平,寒战、牵拉痛评分,手术时间、踝关节运动恢复时间和不同时间点的最大感觉阻滞平面。结果两组麻醉前和麻醉后各时间点的平均动脉压和心率水平差异无统计学意义(P>0.05);观察组注药后各时段的寒战和牵拉疼痛评分低于对照组(P<0.05);两组手术时间、踝关节运动恢复时间和最大感觉阻滞平面,新生儿出生后1 min、5 min Apgar评分,差异无统计学意义(P>0.05)。结论小剂量舒芬太尼作为麻醉剂应用于剖宫产术中防寒战和牵拉疼痛的效果显著,在临床中可推广使用。

Objective To explore the effect of low-dose sufentanil as an anesthetic in preventing chills and traction pain during cesarean section. Methods 98 cases of cesarean section were collected from obstetrics and gynecology in our hospital,and puerperae were randomly divided into two groups. All underwent lumbar and fast combined anesthesia. The study group used sufentanil（ 5 μg） ＋ 0. 75%ropivacaine（ 1. 5 mL） ＋ 10% glucose（ 2. 5 mL）. The control group was treated with 0. 75% ropivacaine（ 1. 5 mL） ＋ 10% glucose（ 2. 5 mL）. The mean arterial pressure and heart rate level,chills,operation time,recovery time of ankle joint movement and the maximum sensory block at different time points were recorded before and after the operation. Results There was no significant difference in the mean arterial pressure and heart rate between the two groups before and after anesthesia（ P〈0. 05）. The scores of chills and traction pain in the study group were significantly lower than those in the control group（ P〈0. 05）. The difference of operative time,the recovery time of the ankle joint movement and the maximum sensory block plane at different time points,Apgar score at 1 minute and5 min after birth between the two groups was not statistically significant（ P〈0. 05）. Conclusion Low dose of sufentanil is used as an anesthetic in the prevention of chills and traumatic pain during cesarean section. It is widely used in clinical practice.