摘要
目的:探讨不同剂量的盐酸羟考酮和右美托咪定复合用于子痫前期患者剖宫产术后镇痛、镇静的有效性和安全性。方法:120例子痫前期患者随机分为A、B、C 3组,各组40例。术后入重症监护病房(ICU)时连接盐酸羟考酮注射液和右美托咪定持续泵注镇痛、镇静治疗。A组采用低剂量盐酸羟考酮每小时0.5 mg+右美托咪定每小时0.3μg/kg持续泵注;B组采用中剂量盐酸羟考酮每小时0.75 mg+右美托咪定每小时0.3μg/kg持续泵注;C组采用高剂量盐酸羟考酮每小时1 mg+右美托咪定每小时0.3μg/kg持续泵注。记录3组患者术毕入ICU时(T0)、入ICU后2小时(T1)、4小时(T2)、6小时(T3)、8小时(T4)、12小时(T5)、24小时(T6)、48小时(T7)静息及按压宫底时的数字疼痛评分法(NRS)评分、按压宫底前后平均血压(MAP)、心率(HR),各时点静息时镇静满意者比例及恶心、呕吐、瘙痒、呼吸抑制、头晕痛等不良反应和子痫、脑出血、心力衰竭等并发症情况。结果:A组中静息NRS评分在T2~T7高于T1(P<0.05);在T2~T5时静息和按压时差异有统计学意义(P<0.05)。A组MAP、HR在T2~T5时点按压前后相比,差异有统计学意义(P<0.05)。B、C两组患者静息、按压NRS评分在T2~T7各时点低于A组(P<0.05);B、C两组间MAP、HR在按压前后各时点比较差异均无统计学意义(P>0.05)。B、C两组镇静满意者例数在T1~T7时点所占比例高于A组(P<0.05)。3组间恶心、呕吐、呼吸抑制发生率差异无统计学意义(P>0.05)。无子痫、脑出血、心力衰竭等并发症发生。结论:盐酸羟考酮每小时0.75mg+右美托咪定每小时0.3μg/kg持续静脉泵注用于子痫前期患者剖宫产术后48小时内镇痛、镇静,安全有效。
Objective:To observe the effects and safety of intravenous Oxycodone hydrochloride combined with Dexmedetomidine for post caesarean section analgesia and sedation of Preeclampsia patients.Methods:120 patients with preeclampsia were randomly divided into group A,group B and group C,each group was 40 patients.After entering ICU,oxycodone hydrochloride and dexmedetomidine were continuously intravenous infused with pump for analgesia and sedation.Group A received low dose oxycodone hydrochloride 0.5 mg/h+dexmedetomidine 0.3μg/(kg·h).Group B received medium dose oxycodone hydrochloride 0.75 mg/h+dexmedetomidine 0.3μg/(kg·h).Group C received high dose oxycodone hydrochloride 1 mg/h+dexmedetomidine 0.3μg/(kg·h).The score of digital pain scoring method(NRS)for resting and pressing uterus was recorded when entering ICU(T0),2 h later(T1),4 h later(T2),6 h later(T3),8 h later(T4),12 h later(T5),24 h later(T6),48 h later(T7).The average blood pressure(MAP),heart rate(HR)before and after pressing the uterus were also recorded.The proportion of patients satisfaction with sedation at each time point of rest,adverse reactions such as nausea,vomiting,pruritus,respiratory depression,dizziness and headache,and complications such as eclampsia,cerebral hemorrhage and heart failure were recorded.Results:The resting NRS score in group A from T2 to T7 was higher than T1(P<0.05).There was statistically significant difference of NRS score between resting time and pressing time at T2~T5(P<0.05).There was statistically significant difference of MAP and HR in group A before and after pressing at T2~T5(P<0.05).The resting and pressing NRS scores of patients in group B and C were lower than those in group A at T2~T7(P<0.05).There was no significant difference in MAP and HR between group B and C before and after pressing at different times(P>0.05).The proportion of satisfaction with sedation in group B and C was higher than that in group A from T1 to T7(P<0.05).There was no significant difference in the incidence of nausea,vomitingand respiratory depression among the three groups(P>0.05).There was no eclampsia,cerebral hemorrhage,heart failure and other complications occurred.Conclusions:Oxycodone hydrochloride 0.75 mg/h+dexmedetomidine 0.3μg/(kg·h)intravenous infusion is safe and effective for analgesia and sedation of preeclampsia patients within 48 hours after cesarean section.
作者
舒丽娟
罗林丽
薛欣盛
赵霞
黄蔚
SHU Lijuan;LUO Linli;XUE Xinsheng(Department of Intensive Care Unit,West China Second University Hospital,Sichuan University,Key Laboratory of Birth Defects and Related Diseases of Women and Children,Ministry of Education,Chengdu Sichuan 610041,China;Department of Anesthesiology,West China Second University Hospital,Sichuan University,Key Laboratory of Birth Defects and Related Diseases of Women and Children,Ministry of Education,Chengdu Sichuan 610041,China)
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2020年第2期149-153,共5页
Journal of Practical Obstetrics and Gynecology
关键词
盐酸羟考酮
右美托咪定
术后镇痛
镇静
子痫前期
剖宫产
Oxycodone hydrochloride
Dexmedetomidine
Postoperative analgesia
Sedation
Preeclampsia
Cesarean section
