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静脉右美托咪定对剖宫产术中镇静效果和不良反应的影响

徐嘉莹 张砡 张秀华 付晨薇 刘俊涛 黄宇光

徐嘉莹, 张砡, 张秀华, 付晨薇, 刘俊涛, 黄宇光. 静脉右美托咪定对剖宫产术中镇静效果和不良反应的影响[J]. 协和医学杂志, 2016, 7(3): 176-179. doi: 10.3969/j.issn.1674-9081.2016.03.003
引用本文: 徐嘉莹, 张砡, 张秀华, 付晨薇, 刘俊涛, 黄宇光. 静脉右美托咪定对剖宫产术中镇静效果和不良反应的影响[J]. 协和医学杂志, 2016, 7(3): 176-179. doi: 10.3969/j.issn.1674-9081.2016.03.003
Jia-ying XU, Yu ZHANG, Xiu-hua ZHANG, Chen-wei FU, Jun-tao LIU, Yu-guang HUANG. Effect of Intravenous Dexmedetomidine on Intraoperative Sedation and Adverse Events in Cesarean Section[J]. Medical Journal of Peking Union Medical College Hospital, 2016, 7(3): 176-179. doi: 10.3969/j.issn.1674-9081.2016.03.003
Citation: Jia-ying XU, Yu ZHANG, Xiu-hua ZHANG, Chen-wei FU, Jun-tao LIU, Yu-guang HUANG. Effect of Intravenous Dexmedetomidine on Intraoperative Sedation and Adverse Events in Cesarean Section[J]. Medical Journal of Peking Union Medical College Hospital, 2016, 7(3): 176-179. doi: 10.3969/j.issn.1674-9081.2016.03.003

静脉右美托咪定对剖宫产术中镇静效果和不良反应的影响

doi: 10.3969/j.issn.1674-9081.2016.03.003
详细信息
    通讯作者:

    黄宇光  电话:010-69152020, E-mail:garybeijing@163.com

  • 中图分类号: R614.2

Effect of Intravenous Dexmedetomidine on Intraoperative Sedation and Adverse Events in Cesarean Section

More Information
  • 摘要:   目的  观察静脉右美托咪定用于腰硬联合麻醉下剖宫产术的镇静效果和对术中不良反应的影响。  方法  选择单胎足月妊娠拟在腰硬联合麻醉下行剖宫产术的产妇50名, 随机数字表法分为右美托咪定组(研究组, 25名)和生理盐水组(对照组, 25名)。蛛网膜下腔穿刺成功后, 给予重比重0.5%布比卡因8 mg, 胎儿娩出后, 研究组予右美托咪定负荷剂量1 μg/kg静脉泵注, 10 min输完后改为0.5 μg/(kg·h)静脉泵注, 对照组予等量生理盐水静脉泵注, 直至术毕。术中每30 min记录产妇的Ramsay镇静评分, 记录术中不良反应和药物副作用发生率, 并记录新生儿出生1、5 min的Apgar评分。  结果  研究组的Ramsay镇静评分显著高于对照组(3.4±0.7比2.2±0.4, P=0.001)。对于术中不良反应, 研究组寒战(0比16%, P=0.001)、恶心呕吐(8%比36%, P=0.019)、手术牵拉导致的腹部不适发生率(12%比48%, P=0.006)均显著低于对照组。对于药物副作用, 研究组心动过缓发生率显著高于对照组(24%比0, P=0.011), 而两组低血压、过度镇静和呼吸抑制发生率差异无统计学意义。两组新生儿Apgar评分差异亦无统计学意义。  结论  静脉右美托咪定可为行腰硬联合麻醉下剖宫产术的产妇提供良好镇静效果, 增加其术中安静合作程度, 降低术中不良反应的发生率, 同时药物副作用较小, 对新生儿无不良影响。
  • 表  1  两组研究对象一般临床资料

    组别 年龄
    (x±s,岁)
    身高
    (x±s,cm)
    体重
    (x±s,kg)
    最高阻滞平面
    [M(min, max)]
    改良Bromage分级
    [M(min, max)]
    手术时间
    (x±s,min)
    用药总量
    (x±s,ml)
    对照组(n=25) 32.0±2.7 164.4±4.9 73.2±5.8 T4(T3, T7) 3(2, 3) 51.4±11.1 28.9±5.7
    研究组(n=25) 32.3±3.8 162.6±5.9 73.8±8.4 T4(T2, T6) 3(2, 3) 58.4±11.9 30.3±5.2
    P 0.812 0.327 0.801 0.862 0.255 0.069 0.403
    下载: 导出CSV

    表  2  两组Ramsay镇静评分和不良反应发生率比较

    组别 Ramsay评分(x±s) 寒战[例(%)] 恶心呕吐[例(%)] 头痛[例(%)] 手术牵拉导致腹部不适[例(%)]
    对照组(n=25) 2.2±0.4 4(16) 9(36) 2(8) 12(48)
    研究组(n=25) 3.4±0.7 0(0) 2(8) 1(4) 3(12)
    P 0.001 0.001 0.019 0.500 0.006
    下载: 导出CSV
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出版历程
  • 收稿日期:  2015-08-25
  • 刊出日期:  2016-05-30

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