右美托咪定复合布托啡诺对剖宫产术后镇痛和恢复的影响

Effects of dexmedetomidine combined with butorphanol on analgesia and recovery after cesarean section

目的探讨右美托咪定复合布托啡诺对剖宫产术后镇痛的效果及术后恢复的影响。方法选取我院2018年2月~2019年6月择期行硬膜外麻醉下剖宫产术的242例产妇作为研究对象,按照随机数字表法分为对照组和实验组,各121例。对照组患者术后给予10mg布托啡诺行自控静脉镇痛(PCIA),实验组在胎儿娩出夹断脐带后立即予以右美托咪定0.5μg/kg静脉泵注,且术后给予右美托咪啶200μg+布托啡诺10mg行PCIA。观察两组患者麻醉不同时间节点的血流动力学变化,术后疼痛视觉模拟评分(VAS)、不良反应情况及术后恢复情况。结果两组患者麻醉不同时间点平均动脉压(MAP)、心率(HR)及血氧饱和度(SpO2)比较差异无统计学意义(P>0.05);实验组各时间点的VAS评分、术后FSS评分及不良反应发生率显著低于对照组(P<0.05),实验组术后QoR-40评分高于对照组(P<0.05)。结论右美托咪定复合布托啡诺对剖宫产术后患者行PCIA可提高镇痛效果,缓解患者术后疲劳、促进术后恢复、安全性高。

Objective To investigate the effects of dexmedetomidine combined with butorphanol on the analgesic effect and postoperative recovery of those after cesarean section.Methods 242 parturients who underwent cesarean section under epidural anesthesia at our hospital from February 2018 to June 2019 were selected as the study objects,and divided into the control group and the experimental group according to the random number table method,with 121 patients in each group.Patients in the control group were administered 10mg of butorphanol for patientcontrolled intravenous analgesia(PCIA),while patients in the experimental group were given intravenous infusion of dexmedetomidine at 0.5μg/kg immediately after fetal delivery and umbilical cord clamping,and administered 200μg of dexmedetomidine and 10mg of butorphanol postoperatively for PCIA.The changes in hemodynamics,visual analogue score(VAS)of postoperative pain,adverse reactions,and postoperative recovery at different time points of anesthesia of the two groups of patients were observed.Results There was no statistically significant difference in the mean arterial pressure(MAP),heart rate(HR),and blood oxygen saturation(SpO2)at different time points of anesthesia between the two groups of patients(P>0.05);the VAS score,postoperative FSS score,and incidence of adverse reactions at each time point in the experimental group were significantly lower than those in the control group(P<0.05),while the postoperative QoR-40 score in the experimental group was higher than that in the control group(P<0.05).Conclusion Dexmedetomidine combined with butorphanol for PCIA in patients after cesarean section can improve the analgesic effect,relieve postoperative fatigue and promote postoperative recovery of patients,with high safety.