右美托咪定复合纳布啡在子宫下段剖宫产术后镇痛中的应用效果研究

Study on application effect of dextrmedetomidine combined with nalbuphine in postoperative analgesia of lower uterine segment caesarean section

目的 分析子宫下段剖宫产产妇予以右美托咪定复合纳布啡实施术后镇痛的临床效果。方法 选取66例需接受子宫下段剖宫产的产妇作为研究对象,随机分为对照组和研究组,每组33例。两组术后均予以静脉自控镇痛,研究组选择右美托咪定+纳布啡+甲氧氯普胺,对照组选择右美托咪定+舒芬太尼+甲氧氯普胺。比较两组术后不同时间点静息疼痛视觉模拟评分法(VAS)评分和运动疼痛VAS评分,术后48 h内镇痛泵按压次数及不良反应发生情况。结果 两组术后2、6、12、24、48 h静息疼痛VAS评分组间比较差异均无统计学意义(P>0.05)。两组术后2、6、12、24、48 h运动疼痛VAS评分组间比较差异均无统计学意义(P>0.05)。两组术后48 h内镇痛泵按压次数比较差异无统计学意义(P>0.05);研究组术后48 h内不良反应发生率仅为9.09%,显著低于对照组的36.36%,差异具有统计学意义(P<0.05)。结论 针对子宫下段剖宫产产妇予以右美托咪定复合纳布啡实施术后镇痛,可以取得十分满意的临床效果,不良反应发生率低,患者满意度高,该方法具有极大的推广应用价值。

Objective To analyze the clinical effect of dextrmedetomidine combined with nalbuphine in postoperative analgesia of lower uterine segment caesarean section. Methods A total of 66 women who required lower uterine segment cesarean section were randomly divided into a control group and a research group, with 33 cases in each group. Both groups were given patient-controlled intravenous analgesia after surgery, with dexmedetomidine + nalbuphine + metoclopramide selected for the research group, while dexmedetomidine +sufentanil + metoclopramide selected for the control group. Both groups were compared in terms of visual analogue scale(VAS) score at rest and movement at different time points after surgery, the number of analgesic pump presses within 48 h after surgery and the occurrence of adverse reactions. Results There was no statistically significant difference in VAS score at rest between the two groups at 2, 6, 12, 24 and 48 h after surgery(P>0.05).There was no statistically significant difference in VAS score at movement between the two groups at 2, 6, 12,24 and 48 h after surgery(P>0.05). There was no statistically significant difference between the two groups in the number of analgesic pump presses within 48 h after surgery(P>0.05). The incidence of adverse reactions within 48 h after surgery in the research group was only 9.09%, which was significantly lower than 36.36% in the control group, and the difference was statistically significant(P<0.05). Conclusion Postoperative analgesia with dexmedetomidine combined with nalbuphine in women undergoing lower uterine segment cesarean section can achieve very satisfactory clinical results with low incidence of adverse reactions and high patient satisfaction. This method is of great value for promotion and application.