右美托咪定联合罗哌卡因用于阴部神经阻滞的临床研究

Clinical Study of Dexmedetomidine Combined with Ropivacaine for Pudendal Nerve Block

目的:分析右美托咪定联合罗哌卡因用于阴部神经阻滞临床效果。方法:选取2019年2月-2020年6月本院收治的210例经阴道分娩且行会阴侧切术的足月单活胎初产妇为研究对象,按照随机数字表法将其均分为A、B、C三组,各70例。A组给予利多卡因,B组给予罗哌卡因,C组给予右美托咪定联合罗哌卡因,比较三组产妇产后疼痛情况、血压、心率、皮质醇、多巴胺、去甲肾上腺素水平、不良反应及产妇满意度。结果:C组产后各时间段疼痛评分均低于A、B组(P<0.05),C组产后收缩压、舒张压均低于A、B组(P<0.05),C组产后心率均低于A、B组(P<0.05)。C组产后2、24 h多巴胺、皮质醇、去甲肾上腺素均低于A、B组(P<0.05)。C组产后不良反应发生率均低于A、B组(P<0.05),C组满意度评分均高于A、B组(P<0.05)。结论:右美托咪定联合罗哌卡因用于阴部神经阻滞可减轻产妇产后疼痛及应激反应,降低产妇不良反应,提高产妇满意度。

Objective:To analyze the clinical effect of Dexmedetomidine combined with Ropivacaine for pudendal nerve block.Method:A total of 210 cases of full-term primiparas with single live fetus who underwent perineal lateral resection after vaginal delivery in our hospital from February 2019 to June 2020 were selected as the research objects,according to the random number table method,they were divided into group A,B and C,70 cases in each group.Group A was given Lidocaine,group B was given Ropivacaine,group C was given Dexmedetomidine combined with Ropivacaine.Postpartum pain,blood pressure,heart rate,cortisol,dopamine,norepinephrine levels,adverse reactions and maternal satisfaction were compared among three groups.Result:The postpartum pain scores of group C were lower than those of group A and B at various time periods(P<0.05),the postpartum systolic and diastolic blood pressure of group C were lower than those of group A and B(P<0.05),the postpartum heart rate of group C was lower than that of group A and B(P<0.05).Dopamine,cortisol and norepinephrine in group C at postpartum 2 and24 h were lower than that in group A and B(P<0.05).The incidence of postpartum adverse reactions in group C was lower than those in group A and B(P<0.05),the satisfaction score in group C was higher than that in group A and B(P<0.05).Conclusion:Dexmedetomidine combined with Ropivacaine for pudendal nerve block can reduce postpartum pain and stress response,reduce maternal adverse reactions,improve maternal satisfaction.