右美托咪定静脉泵注在腰-硬联合麻醉剖宫产手术中对产妇止痛效果的影响

The Effect of Intravenous Infusion of Dexmedetomidine on Pain Relief in Parturients Undergoing Cesarean Section under Combined Lumbar Epidural Anesthesia

目的分析并探究剖宫产手术中采用右美托咪定静脉泵注腰-硬联合麻醉后产妇的止痛效果。方法选择2021年2月至2023年2月进行剖宫产的98例产妇作为研究对象,对其随机分组后,参照组采用生理盐水与罗哌卡因进行麻醉,实验组通过罗哌卡因联合右美托咪定进行静脉泵注麻醉,两组均采取腰-硬联合麻醉的方式。观察两组产妇不同时段[麻醉前(T1)、麻醉后5min(T2)、麻醉后20min(T3)、胎儿娩出时(T4)]血流动力学指标[心率(HR)、平均动脉压(MAP)]、产后各时段(6h、12h、24h、48h)疼痛程度(VAS评分)、新生儿分娩2min、5min后阿氏(Apgar)评分与产妇不良反应发生情况。结果两组产妇T1时段HR、MAP指标、T2时段MAP指标、产后6h的VAS评分、新生儿分娩后2min、5min的Apgar评分、不良反应发生率差异比较均不明显(P>0.05),但实验组产妇T2时段HR指标、T3、T4时段HR、MAP指标与参照组相比较高,产后12h、24h与48hVAS评分相较于参照组则较低,各组数值对比差异明显(P<0.05)。结论在剖宫产手术中产妇采用右美托咪定静脉泵注腰-硬联合麻醉,不但对产妇术中血流动力学影响较小,产后止痛效果良好,还不易引发不良反应,具有较高的麻醉安全性,适合用于临床推广。

Objective To analyze and explore the analgesic effect of intravenous infusion of dexmedetomidine combined with lumbar epidural anesthesia in cesarean section surgery in parturients.Method 98 parturients who underwent cesarean section from February 2021 to February 2023 were selected as the study subjects.After randomization,the control group was anesthetized with saline and ropivacaine,while the experimental group was anesthetized with ropivacaine combined with dexmedetomidine via intravenous infusion.Both groups received combined lumbar epidural anesthesia.Observe the hemodynamic indicators(heart rate(HR)and mean arterial pressure(MAP))of two groups of parturients at different time periods(T1 before anesthesia,T25 minutes after anesthesia,T320 minutes after anesthesia,T4 delivery),VAS score at different postpartum time periods(6h,12h,24h,48h),Apgar score at 2 minutes and 5 minutes after delivery,and incidence of adverse reactions in parturients.Result There was no significant difference(P>0.05)in the HR and MAP indicators,T2 MAP indicators,VAS scores at 6 hours postpartum,Apgar scores at 2 and 5 minutes after delivery,and incidence of adverse reactions between the two groups of parturients.However,the experimental group had higher HR indicators,T3,T4 HR and MAP indicators compared to the reference group,and lower VAS scores at 12,24,and 48 hours postpartum compared to the reference group,with significant differences in values between the groups(P<0.05).Conclusion In cesarean section surgery,the use of dexmedetomidine intravenous pump combined with lumbar epidural anesthesia in parturients not only has a small impact on intraoperative hemodynamics,good postpartum pain relief effect,but also is less likely to cause adverse reactions.It has high anesthesia safety and is suitable for clinical promotion.