不同剂量酒石酸布托啡诺对腰硬联合麻醉剖宫产产妇寒战发生的影响

Effect of different doses of Butorphanol Tartrate on the occurrence of chills in parturients during cesarean section under combined spinal and epidural anesthesia

目的探讨不同剂量酒石酸布托啡诺(BT)对腰硬联合麻醉剖宫产产妇寒战发生的影响。方法选取2019年1月—2020年7月安徽省滁州市第一人民医院产科收治的84例行腰硬联合麻醉剖宫产产妇为研究对象,按照随机数字表法分为A组(42例)、B组(42例)。A组术中采用1mg的BT,B组术中采用2 mg的BT。比较两组寒战发生情况、镇静情况、新生儿出生情况及不良反应发生情况。结果B组寒战总发生率低于A组,差异有统计学意义(P<0,05)。B组胎儿娩出后5、10 min的Ramsay镇静评分高于A组,差异均有统计学意义(均P<0,05)。两组1、5、10 min的Apgar评分比较,差异无统计学意义(P>0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论在腰硬联合麻醉剖宫产产妇中应用BT安全性良好,对新生儿无呼吸抑制,与1 mg BT比较,2 mg BT可明显减少寒战的发生且镇静效果更佳。

Objective To explore the effect of different doses of butorphanol tartrate(BT)on the occurrence of chills in parturients during cesarean section under combined spinal and epidural anesthesia.Methods From January 2019 to July 2020,84 parturients receiving cesarean section under combined spinal and epidural anesthesia who admitted to Department of Obstetrics,the First People’s Hospital of Chuzhou,Anhui Province were selected as the research subjects.They were divided into group A(42 cases)and group B(42 cases)according to the random number table method.Group A received 1 mg BT intraoperatively,and group B received 2 mg BT intraoperatively.The occurrence of chills,sedation,newborn birth and adverse reactions were compared between two groups.Results The total incidence of chills in group B was lower than that in group A,and the difference was statistically significant(P<0.05).The Ramsay sedation score 5 and 10 min after delivery of fetus in group B were higher than those in group A,and the differences were statistically significant(all P<0.05).There were no significant differences in Apgar scores of two groups at 1,5,and 10 min after birth(P>0.05).There was no statistically significant difference in total incidence of adverse reactions between two groups(P>0.05).Conclusion It is safe to use BT in parturients during cesarean section with combined spinal and epidural anesthesia and has no respiratory depression for newborns.Compared with 1 mg BT,2 mg BT can significantly reduce the occurrence of chills and have a better sedative effect.