右美托咪定在重度子痫前期患者剖宫产术后疼痛及恢复效果的影响

Effects of dexmedetomidine on postoperative pain and postoperative recovery in patients with severe preeclampsia after caesarean section

目的研究重度子痫前期患者行剖宫术后应用右美托咪定对其疼痛及恢复效果的影响。方法选取2016年1月至2017年1月治疗的200例重度子痫前期行剖宫产术的产妇作为研究对象,按照随机数字表法将200例研究对象随机分成观察组和对照组,每组100例。观察组剖宫产术后给予50 ml 0.9%氯化钠溶液注射液+2 ml盐酸右美托咪定注射液,持续静脉泵入,以5 ml/h维持;对照组术后静脉注射质量分数为20%的硫酸镁30 mg/kg,5 min以内注射完毕,之后以每小时15 mg/kg的剂量进行维持。比较2组患者术后6、12、24 h的收缩压(SBP)、舒张压(DBP)、心率(HR)、呼吸(R);不良反应的发生率及VAS疼痛评分。结果术后6~24 h,2组患者的SBP、DBP和心率均较前下降,且观察组SBP、DBP术后下降幅度均大于对照组,差异有统计学意义(P<0.05)。观察组的恶心、呕吐和皮肤瘙痒的发生率分别为4.00%、6.00%和11.00%,均明显低于对照组的15.00%、15.00%和24.00%,差异均有统计学意义(P<0.05)。术后12、24 h观察组的VAS评分(0~3分的病例数分别为:60例、68例)低于对照组,差异有统计学意义(P<0.05)。结论重度子痫前期患者在剖宫术后应用右美托咪定时,其镇痛效果较优于硫酸镁;且可改善患者心率、血压,降低恶心、呕吐、皮肤瘙痒等不良反应的发生率,促使术后的恢复。

Objective To investigate the effects of dexmedetomidine on postoperative pain and postoperative recovery in patients with severe preeclampsia after caesarean section.Methods A total of 200 patients with severe preeclampsia who were treated in our hospital from January 2016 to January 2017 were enrolled in the study,who were randomly divided into observation group(n=100)and control group(n=100)according to random number table method.After cesarean section,the patients in observation group were gaving 0.9%sodium chloride solution 50ml+dexmedetomidine hydrochloride injection 2ml,continuous intravenous pumping,at 5ml/h,however,the patients in control group were gaving Magnesium Sulfate(quality score of intravenous injection 20%)30mg/kg,finished within 5min,followed by a dose of 15mg/kg per hour.The systolic blood pressure(SBP),diastolic pressure(DBP),heart rate(HR)and respiration(R)as well as the incidence rate of adverse reactions and VAS pain score were observed and compared between the two groups.Results At 6~24h after operation,the levels of SBP,DBP and heart rate were decreased,moreover,the decrease degree in observation group was more significant than that in control group(P<0.05).The incidence rates of nausea,vomiting and itching in observation group were 4.00%,6.00%and 11.00%,respectively,which were significantly lower than those(15.00%,15.00%,24.00%)in control group(P<0.05).Moreover the VAS scores in observation group were significantly lower than those in control group(P<0.05).Conclusion The analgesic effects of dexmedetomidine for patients with severe preeclampsia after caesarean section are superior to those of magnesium sulfate,which can improve the patient’s heart rate and blood pressure,reduce the incidence rates of nausea,vomiting,itching and other adverse reactions,and promote postoperative recovery of patients.