右美托咪定复合罗哌卡因腹横肌平面阻滞对剖宫产产妇术后镇痛效果及新生儿结局的影响

Influence of Dexmedetomidine combined with Ropivacaine transversus abdominis plane block on postoperative analgesia effect and neonatal outcome in parturients with cesarean section

目的探讨右美托咪定复合罗哌卡因腹横肌平面阻滞对剖宫产产妇术后镇痛效果及新生儿结局的影响。方法选取2022年6月至2023年12月于喀什地区第二人民医院行剖宫产手术的120例产妇作为研究对象,按随机数字表法分为两组,每组各60例。对照组采用罗哌卡因进行腹横肌平面阻滞,观察组在对照组基础上复合右美托咪定。比较两组镇痛效果、血流动力学、新生儿结局及不良反应发生情况。结果观察组术后6、12、24 h的视觉模拟评分法评分均低于对照组(P<0.05)。观察组麻醉10 min后、胎儿娩出后、术毕的心率、平均动脉压均较对照组低(P<0.05)。两组新生儿出生1、5 min后的新生儿Apgar评分及不良反应总发生率比较,差异无统计学意义(P>0.05)。结论右美托咪定复合罗哌卡因腹横肌平面阻滞在剖宫产产妇中应用可提高术后镇痛效果,稳定血流动力学指标,对新生儿结局影响较小,且不增加不良反应。

Objective To explore the influence of Dexmedetomidine combined with Ropivacaine transversus abdominis plane block on postoperative analgesia effect and neonatal outcome in parturients with cesarean section.Methods A total of 120 parturients who underwent cesarean section surgery in the Second People’s Hospital of Kashgar Prefecture from June 2022 to December 2023 were selected as the study objects.All the parturients were divided into two groups using the random number table method,with 60 cases in each group.The control group received Ropivacaine for transversus abdominis plane block,while the obs ervation group combined with Dexmedetomidine on the basis of the control group.The analgesic effect,hemodynamics,neonatal outcomes,and incidence of adverse reactions were compared between the two groups.Results The visual analogue scale scores at 6,12,and 24 hours after surgery of the observation group were lower than those of the control group(P<0.05).The heart rate and mean arterial pressure at 10 minutes after anesthesia,fetal delivery,and completion of surgery in the observation group were lower than those in the control group(P<0.05).There were no statistically significant differences in the neonatal Apgar scores at 1 and 5 minutes after birth and total incidence of adverse reactions between the two groups(P>0.05).Conclusion The application of Dexmedetomidine combined with Ropivacaine transversus abdominis plane block in parturients with cesarean section can improve postoperative analgesia effect,stabilize hemodynamic indicators,has a small impact on neonatal outcomes,and does not increase adverse reactions.