羟考酮降低剖宫产术中卡前列素氨丁三醇所致不良反应的效果

Effects of oxycodone on reducing the adverse reactions caused by carboprost tromethamine in cesarean section

目的观察羟考酮降低剖宫产术中卡前列素氨丁三醇不良反应的效果。方法选取2018年3月至2019年3月廊坊市第四人民医院产科诊治的80例宫缩乏力剖宫产产妇为研究对象,将其随机分为观察组和对照组,每组40例产妇。两组产妇均于胎儿娩出后立即行卡前列素氨丁三醇250μg宫体注射。观察组产妇镇痛泵输入0.5mg·kg-1羟考酮,对照组产妇于胎儿娩出后静脉注射生理盐水2 mL。观察两组产妇卡前列素氨丁三醇注射后2 min(T1)、5 min(T2)、10 min(T3)平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO2)。记录两组产妇术后6h、12h、24h时的视觉模拟疼痛评分(visual analogue scale,VAS)静息痛评分和Ramsay镇静评分,以及两组产妇不良反应发生情况。结果①两组产妇T1、T3时MAP、HR、SpO2比较,其差异均无统计学意义(均P>0.05),观察组产妇T2时MAP、HR明显低于对照组产妇,其差异均具有统计学意义(均P<0.05)。②观察组产妇6h、12h、24 h时的VAS评分明显低于对照组产妇,其差异均具有统计学意义(均P<0.05);12h时的Ramsay评分明显高于对照组产妇,其差异具有统计学意义(P<0.05)。③观察组产妇恶心、呕吐、面部潮红、胸闷憋气、血压升高、头痛眩晕的发生率明显低于对照组产妇,其差异均具有统计学意义(均P<0.05)。结论羟考酮对剖宫产术中卡前列素氨丁三醇所致的不良反应有一定防治作用,有利于产妇生命体征的稳定,具有确切的镇痛和镇静效果。

Objective To observe the effects of oxycodone on reducing the adverse reactions caused by carboprost tromethamine in cesarean section. Methods 80 cases of caesarean section due to uterine inertia in our hospital from March 2018 to March 2019 were divided randomly into the observation group(n=40) and control group(n=40). The patients in two groups were injected carboprost tromethamine 250 μg right after fetal childbirth and rupture of umbilical cord. The patients in the observation group were infused oxycodone 0.5 mg·kg-1 by analgesia pump, and patients in control group were injected intravenously saline 2 mL at the moment of fetal childbirth. Mean arterial pressure(MAP), heart rate(HR), oxygen saturation(SpO2) at 2 min(T1), 5 min(T2), 10 min(T3) after the injection of carboprost tromethamine were observed in two groups. VAS and Ramsay scores at 6, 12, 24 h after operation and the incidence of adverse reactions were recorded in the two groups. Results ① There was no statistically significant differences in the MAP, HR, SpO2 at T1 and T3 between the two groups(all P>0.05). MAP and HR at T2 in the observation group were lower than those in control group, with statistically significant differences(P<0.05). ②VAS scores at 6 h,12 h, 24 h in the observation group were lower than those in control group and the Ramsay scores at 12 h were higher than those in control group, all with statistically significant differences(all P<0.05). ③ The incidences of adverse reactions such as nausea, vomiting, flushed face, tight chest, high blood pressure and dizziness in the observation group were lower than those in control group, with statistically significant differences(all P<0.05). Conclusions Oxycodone can prevent effectively the adverse reactions caused by carboprost tromethamine in cesarean section, and beneficial to the stability of vital signs with analgesia and sedation effects.