基础医学与临床 ›› 2018, Vol. 38 ›› Issue (3): 390-393.

• 临床研究 • 上一篇    下一篇

右美托咪定联合布托啡诺对剖宫产术后镇痛和恢复的作用

孙巧霞,王瑞雯,李志,刘少慧,王朋朋,常江涛,马加海   

  1. 青岛大学附属烟台毓璜顶医院
  • 收稿日期:2017-09-21 修回日期:2017-12-19 出版日期:2018-03-05 发布日期:2018-02-27
  • 通讯作者: 马加海 E-mail:mjh-214@163.com
  • 基金资助:
    山东省医药卫生科技发展项目

Effects of dexmedetomidine combined with butorphanol on postoperative analgesia and recovery in cesarean section

  • Received:2017-09-21 Revised:2017-12-19 Online:2018-03-05 Published:2018-02-27

摘要: 目的 观察右美托咪定联合布托啡诺用于剖宫产术后患者自控静脉镇痛(PCIA)的效果,以及对患者术后恢复的影响。方法 择期硬膜外麻醉下行剖宫产术初产妇84例,随机分为对照组:术后行PCIA,给予布托啡诺10 mg;实验组:胎儿娩出夹闭脐带后即刻静脉泵注右美托咪定0.5 μg/kg,术后行PCIA,给予右美托咪啶200 μg+布托啡诺10 mg。监测并记录平均动脉压(MAP)、心率(HR)和脉搏血氧饱和度(SpO2);术后对疼痛视觉模拟评分(VAS)、镇静评分和不良反应观察记录;术后对24 h镇痛泵总按压次数以及追加补救镇痛药种类、次数记录。采用QoR-40量表(QoR-40)和FSS疲劳量表(FSS)评估产妇术后恢复情况。 结果 与对照组比较,实验组患者各时间点VAS评分、不良反应发生率和术后FSS疲劳量表评分均显著降低(P <0.05);镇痛泵按压次数显著减少(P <0.05);术后第3天QoR-40量表评分显著增高(P <0.05)。结论 右美托咪定联合布托啡诺用于剖宫产术后PCIA可以减少布托啡诺的使用量,并且能够缓解患者术后疲劳,促进术后恢复。

关键词: 右美托咪定, 布托啡诺, 患者自控静脉镇痛, 术后镇痛, 术后恢复

Abstract: Objective The present study was designed to investigate the effects of dexmedetomidine combined with butorphanol on postoperative analgesia and recovery for patient-controlled intravenous analgesia (PCIA) in parturients undergoing cesarean section. Methods Eighty-four parturients scheduled for elective caesarean section under spinal anaesthesia were randomly allocated into two groups. Control group: physiological saline infusion (0.5 ?g/kg) after delivery and butorphanol (10 mg) in PCIA. Experimental group: dexmedetomidine (0.5 ?g/kg ) infusion after delivery and dexmedetomidine (200 ?g) with butorphanol (10 mg) in PCIA. Hemodynamic variables, the visual analogue score (VAS), the sedation score, side effects, the total pump-press number and additional analgesics cases were recorded. The quality of recovery was evaluated by using a 40-item quality of recovery questionnaire (QoR-40) and a 9 questions fatigue score (FFS). Results Compared with control group, the VAS scores, the total pump-press number, the incidence of side effects and the FSS scores in experimental group was significantly decreased (P <0.05). In addition, the QoR-40 score at POD3 was significantly increased (P <0.05). Conclusions Dexmedetomidine combined with butorphanol for PCIA after caesarean section decreases the consumption of butorphanol, promotes postoperative analgesia, alleviates fatigue, and improves postoperative recovery.

Key words: dexmedetomidine, butorphanol, patient-controlled intravenous analgesia, postoperative analgesia, postoperative recovery

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