摘要
目的分析不同剂量布托啡诺对剖宫产术后产妇血清催乳素(PRL)、5-羟色胺、脂质过氧化氢(LHP)水平的影响。方法前瞻性选取2023年1月至2024年1月在济宁医学院附属医院行剖宫产的124例产妇作为研究对象,按随机数字表法分为研究1组(41例)、研究2组(41例)和研究3组(42例),三组术后均行患者自控镇痛,镇痛药物均使用0.2 mg芬太尼,但是布托啡诺剂量为研究1组100 mg/L,研究2组120 mg/L,研究3组140 mg/L。比较三组手术前后不同时点PRL水平及首次泌乳时间,比较三组术后不同时点5-羟色胺、LHP水平,比较三组术后不同时点Ramsay评分和视觉模拟量表(VAS)评分,比较三组不良反应发生情况及镇痛效果满意度。结果术后24、48、72 h,研究3组PRL水平高于研究2组和研究1组[(383.02±47.57)μg/L比(376.39±46.83)和(302.88±41.38)μg/L、(412.38±40.22)μg/L比(394.82±38.30)和(315.09±37.93)μg/L、(434.39±39.39)μg/L比(427.48±40.27)和(344.39±42.78)μg/L],差异有统计学意义(P<0.05);研究2组、研究3组首次泌乳时间低于研究1组[(50.31±6.52)、(49.54±6.27)h比(53.91±8.42)h],差异有统计学意义(P<0.05)。在术后2 h(T_(1))、12 h(T_(2))、24 h(T_(3))、48 h(T_(4)),研究3组、研究2组和研究1组5-羟色胺水平依次升高,LHP水平依次降低,差异有统计学意义(P<0.05)。在术后30 min(T_(0))、T_(1)、T_(2)、T_(3)、T_(4)时点,研究3组、研究2组和研究1组Ramsay评分依次升高,VAS评分依次降低,差异有统计学意义(P<0.05)。三组不良反应发生率比较差异无统计学意义(P>0.05)。研究3组总满意度高于研究2组和研究1组[92.86%(39/42)比73.17%(30/41)、68.29%(28/41)],差异有统计学意义(Z=2.52,P=0.008)。结论140 mg/L布托啡诺对剖宫产术后镇痛效果更为显著,并可改善血清PRL、5-羟色胺、LHP水平,降低不良反应发生,提高镇痛满意度。
Objective To analyze the effects of different doses of butorphanol on prolactin,serotonin and lipid hydrogen peroxide after cesarean section.Methods A total of 124 women who underwent cesarean section in the Affiliated Hospital of Jining Medical University from January 2023 to January 2024 were prospectatively selected as study subjects,and divided into the study group 1(41 cases),study group 2(41 cases)and study group 3(42 cases)according to random number table method.All three groups underwent patient-controlled analgesia after surgery,and 0.2 mg fentanyl was used as analgesic drug.However,the doses of butorphanol were 100 mg/L in the study group 1,120 mg/L in the study group 2,and 140 mg/L in the study group 3.The level of PRL and first lactation time before and after surgery were compared among the three groups at different time points,serotonin and LHP levels were compared among the three groups at different time points after surgery,Ramsay and visual analog scale(VAS)scores were compared among the three groups at different time points after surgery,and the occurrence of adverse reactions and satisfaction with analgesic effect were compared among the three groups.Results At 24,48 and 72 h after operation,the level of PRL in the study group 3 was higher than that in the study group 2 and study group 1:(383.02±47.57)μg/L vs.(376.39±46.83),(302.88±41.38)μg/L;(412.38±40.22)μg/L vs.(394.82±38.30),(315.09±37.93)μg/L;(434.39±39.39)μg/L vs.(427.48±40.27),(344.39±42.78)μg/L,there were statistical differences(P<0.05).The first lactation time in the study group 2 and study group 3 was lower than that in the study group 1:(50.31±6.52),(49.54±6.27)h vs.(53.91±8.42)h,there was statistical difference(P<0.05).At 2 h(T_(1)),12 h(T_(2)),24 h(T_(3))and 48 h(T_(4))after surgery,the levels of serotonin in the study group 3,study group 2 and study group 1 were increased successively,and the levels of LHP were decreased successively,there were statistical differences(P<0.05).At 30 min after surgery(T_(0)),T_(1),T_(2),T_(3)and T_(4),the Ramsay score in the study group 3,study group 2 and study group 1 were increased successively,and the VAS score were decreased successively,there were statistical differences(P<0.05).There was no significant difference in the incidence of adverse reactions among the three groups(P>0.05).The total satisfaction of study group 3 was higher than that of study group 2 and study group 1:92.86%(39/42)vs.73.17%(30/41),68.29%(28/41),there was statistical difference(Z=2.52,P=0.008).Conclusions Butorphanol 140 mg/L has a more significant analgesic effect after cesarean section,and can improve the levels of serum PRL,serotonin and LHP,reduce the occurrence of adverse reactions,and improve the satisfaction of analgesia.
作者
朱永宁
许丹妮
杨爽
谢宁
仙娜
贾志
Zhu Yongning;Xu Danni;Yang Shuang;Xie Ning;Xian Na;Jia Zhi(Department of Obstetrics,Affiliated Hospital of Jining University,Jining 272100,China;Department of Anesthesiology,Affiliated Hospital of Jining University,Jining 272100,China)
出处
《中国医师进修杂志》
2025年第6期510-515,共6页
Chinese Journal of Postgraduates of Medicine
基金
济宁市重点研发计划(2022YXNS070)。
关键词
剖宫产术
镇痛
病人控制
布托啡诺
催乳素
血清素
脂质过氧化氢
Cesarean section
Analgesia,patient-controlled
Butorphanol
Prolactin
Serotonin
Lipid hydrogen peroxide
