不同剂量纳布啡预防腰-硬联合麻醉剖宫产产妇寒战的效果

The Effect of Different Doses of Nalbuphine in Preventing Chills in Cesarean Section Women under Combined Lumbar-epidural Anesthesia

目的:分析在腰-硬联合麻醉剖宫产中应用不同剂量纳布啡对寒战的预防效果。方法:选取2020年1月-2021年10月在嘉陵区妇幼保健院进行剖宫产手术分娩的200例产妇作为研究对象,采用随机分组的方法分为五组,各40例。研究组1、研究组2、研究组3、研究组4在胎儿娩出夹闭脐带即刻注射纳布啡,剂量分别为0.05 mg/kg、0.1 mg/kg、0.15 mg/kg、0.2 mg/kg,对照组注射等容量的生理盐水,对药物使用效果进行分析。结果:研究组2、研究组3、研究组4寒战发生率低于对照组及研究组1,差异有统计学意义(P<0.05);研究组2、研究组3、研究组4牵拉痛发生率低于对照组及研究组1,差异有统计学意义(P<0.05);产妇不同节点平均动脉压比较,差异有统计学意义(P<0.05);研究组4不良反应发生率高于对照组、研究组1、研究组2组及研究组3组,差异有统计学意义(P<0.05)。结论:预防腰-硬联合麻醉剖宫产产妇寒战中,0.1 mg/kg及0.15 mg/kg剂量的纳布啡效果较为理想,值得推广。

Objective:To analyze the effect of different doses of nalbuphine in preventing chills in cesarean section women under combined lumbar-epidural anesthesia.Methods:From January 2020 to October 2021,200 puerperae who underwent cesarean section in Jialing District Maternal and Child Health Hospital were selected as the research subjects.The patients were randomly divided into five groups with 40 cases in each group.study group1,2,3 and 4 were injected with nalbuphine immediately after the fetus was delivered by clipping the umbilical cord,at the doses of 0.05 mg/kg,0.1 mg/kg,0.15 mg/kg,and 0.2 mg/kg,respectively.The control group was injected with the same volume of normal saline to analyze the effect of drug use.Results:The incidence of chills in study group 2,3 and 4 was lower than that in the control group and study group 1,and the difference was statistically significant(P<0.05).The incidence of stretch pain in study group 2,3 and 4 was lower than that in control group and study group 1,and the difference was statistically significant(P<0.05).There was statistically significant difference in mean arterial pressure at different nodes(P<0.05).The incidence of adverse reactions in study group 4 was higher than that in control group,study group 1,study group 2,and study group 3,and the difference was statistically significant(P<0.05).Conclusion:In the prevention of chills in cesarean section women under combined lumbar-epidural anesthesia,nalbuphine at doses of 0.1 mg/kg and 0.15 mg/kg is more effective and is worthy of promotion.