地佐辛联合咪达唑仑或芬太尼防治剖宫产术中胃牵拉痛和寒战的效果观察

Effects of dizosin combined with midazolam or with fentanyl in the prevention and treatment of gastric traction pain and shivering during cesarean section

  • 摘要: 目的 探讨地佐辛联合咪达唑仑或芬太尼防治腰-硬联合麻醉下剖宫产术中胃牵拉痛和寒战的效果。 方法 选取行腰-硬联合麻醉下剖宫产术患者120例,随机分为3组,每组40例。胎儿取出后即刻,A组静脉滴注地佐辛0.10 mg/kg, B组静脉滴注地佐辛0.10 mg/kg及咪达唑仑0.03 mg/kg, C组静脉滴注地佐辛0.10 mg/kg及芬太尼0.1 mg。观察给药即刻产妇的无创动脉血压(NIBP)、心率(HR)、呼吸频率(RR)、血氧饱和度(SpO2)的变化,以及给药前(T0)、给药后5 min(T1)、给药后30 min(T2)、给药后60 min(T3)产妇的Ramsay 评分、胃牵拉痛评分、寒战发生情况。 结果 3组产妇术中NIBP、HR、RR、SpO2比较,差异无统计学意义(P>0.05)。A组、B组、C组不良反应发生率依次为2.5%、2.5%、12.5%, 差异无统计学意义(P>0.05)。B组、C组产妇T1、T2、T3的Wrench寒战评分显著低于A组(P<0.05)。3组产妇T1、T2、T3的Ramsay镇静评分比较,差异有统计学意义(P<0.05)。B组、C组T1、T2、T3的胃牵拉痛视觉模拟评分法(VAS)评分均显著低于A组(P<0.05)。 结论 地佐辛复合咪达唑仑或芬太尼可减轻剖宫产术中胃牵拉痛和寒战反应程度,且产妇呼吸循环稳定,镇静适度,维持时间长且镇痛效果满意,不良反应较少。

     

    Abstract: Objective To explore the clinical effects of dizocine combined with midazolam or with fentanyl in the prevention and treatment of gastric stretch pain and shivering in cesarean section under lumbar-epidural anesthesia. Methods A total of 120 cesarean section puerperas under lumbar-epidural anesthesia were randomly divided into 3 groups, with 40 cases in each group. Immediately after the birth of the fetus, group A received 0.10 mg/kg of intravenous infusion of dizocine, and group B received 0.10 mg/kg of intravenous infusion of dizocine as well as 0.03 mg/kg of midazolam, and group C received 0.10mg/kg of intravenous infusion of dizocine as well as fentanyl for 0.1 mg. The changes of noninvasive arterial blood pressure(NIBP), heart rate(HR), respiratory rate(RR), blood oxygen saturation(SpO2)were observed in the parturient women immediately after drug intravenous infusion, The Ramsay score and stomach-stretching pain score and shivering before drug administration(T0), at 5 min(T1), 30 min(T2)and 60 min(T3)after drug administration were observed. Results There were no significant differences in NIBP, HR, RR SpO2 among three groups(P>0.05). The incidence of adverse reactions was 2.5% in A group, 2.5% in group B, and 12.5% in group C, but no significant differences were observed(P>0.05). The Wrench shivering scores at T1, T2 and T3 in groups B and C were lower than group A(P<0.05). The Ramsay sedation scores at T1, T2 and T3 in three groups showed significant differences(P< 0.05). At T1, T2 and T3, Visual Analogue Scale(VAS)score in group C and group B was significantly lower than that - of group A(P<0.05). Conclusion Dizocine combined with midazolam or with fentanyl, with less adverse reaction, can reduce the degree of gastric stretch pain and shivering reaction during cesarean section, and can stabilize the respiratory and circulatory system of puerperas, maintain longer time in analgesia and better satisfaction in analgesia efficacy, and has a milder sedation.

     

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