舒芬太尼预防性镇痛对剖宫产术产妇VAS评分及应激指标影响

Effect of sufentanil prophylactic analgesia on VAS score and stress index of women who experienced cesarean section

目的:观察舒芬太尼预防性镇痛在剖宫产术中的应用效果,及对产妇镇痛VAS评分、血糖和皮质醇水平的影响。方法:以2017年2月-2018年6月在本院接受剖宫产术产妇80例为研究对象,分为传统麻醉组和预防性镇痛组,每组40例。比较两组围手术期血流动力学、血糖、皮质醇等应激指标和VAS评分。结果:手术后2h预防性镇痛组平均动脉压(87.47±3.75mmHg)、心率R(81.0±5.1次/分),以及血糖(4.23±0.95mmol/L)、皮质醇(362.45±16.24ng/ml)、肿瘤坏死因子-α(23.18±4.27pg/ml)均低于传统麻醉组(P<0.001);两组术后镇静效果(Ramsay评分)无差异,预防性镇痛组术后4h、12h的VAS评分(2.4±1.1分、1.5±0.7分)均低于传统麻醉组(P<0.001)。结论:舒芬太尼预防性镇痛在剖宫产术中的应用效果较好,产妇应激反应小,具有良好的临床应用价值。

Objective: To observe the effect of sufentanil for preventive analgesia during cesarean section, and to study its influence on the maternal analgesic VAS score, and the levels of blood glucose and cortisol. Methods: From February 2017 to June 2018, 80 women with cesarean section were divided into study group and control group(40 cases in each group). The stress indexes, such as hemodynamic, blood glucose and cortisol, and VAS scores during perioperative period of women were compared between the two groups. Results: MAP(87.47±3.75 mmHg), HR(81.0±5.1 times/min), blood glucose level(4.23±0.95 mmol/L), cortisol level(362.45±16.24 ng/ml), and TNF-αlevel(23.18±4.27 pg/ml) of women in the study group at 2 hours after surgery were all significant lower than those of women in the control group(P<0.001), but there was no significant difference in postoperative sedation effect(Ramsay score) of women between the two groups. VAS scores of women in the study group at 4 and 12 hours after surgery were 2.4±1.1 points and 1.5±0.7 points, which were significant lower than those of women in the control group(P<0.001). Conclusion: The effect of sufentanil for preventive analgesia during cesarean section is good, and the stress response of parturient is less, so it has good clinical application value.