摘要/Abstract

摘要： 目的·观察右美托咪定复合舒芬太尼用于重度子痫前期剖宫产产妇术后自控静脉镇痛（patient-controlled intravenous analgesia，PCIA）的效果。方法·随机数字表格法将拟行剖宫产手术的250例重度子痫前期产妇分为观察组与对照组，各125例；术后均行PCIA，观察组PCIA配方为右美托咪定复合舒芬太尼，对照组PCIA配方为单纯舒芬太尼；比较2组不同时间点心率（HR）、平均动脉压（MAP），记录2组术后4、8、24 h疼痛视觉模拟评分（visual analogue scale，VAS）、镇静评分（Ramsay sedation scale，RSS）、舒芬太尼用量、药物不良反应情况。结果·观察组术后4、8、24 h HR、MAP水平均显著低于对照组，差异有统计学意义（均P<0.05）；观察组术后4、8、24 h VAS评分均显著低于对照组，RSS评分均显著高于对照组，舒芬太尼用量均显著少于对照组（均P<0.05）；观察组恶心、呕吐发生率分别为12.80%和7.20%，均显著低于对照组的32.00%和16.00%（均P<0.05）。结论·右美托咪定复合舒芬太尼相比单纯舒芬太尼用于重度子痫前期剖宫产产妇术后PCIA，不仅能明显增强镇痛、镇静效果，而且能明显减少舒芬太尼用量，减少药物不良反应。
关键词: 重度子痫前期, 右美托咪定, 舒芬太尼, 自控静脉镇痛
Abstract:
Objective · To investigate the effects of dexmedetomidine combined with sufentanil in patient-controlled intravenous analgesia (PCIA) of puerperae with severe preeclampsia after cesarean section. Methods · A total of 250 puerperae with severe preeclampsia who prepared to be treatedcesarean section were divided into observation group and control groupthe random number method with 125 cases in each group. They were given PCIA after operation. The PCIA formula for the observation group was dexmedetomidine combined sufentanil while that for the control group was sufentanil alone. The heart rate (HR) and mean arterial pressure (MAP) were compared between the two groups at different time points. Scores of visual analogue scale (VAS) and Ramsay sedation scale (RSS), the dosage of sufentanil and adverse drug reactions in both groups were recorded at 4, 8 and 24 hours after operation. Results · The HR and MAP of the observation group were significantly lower than those of the control group at 4, 8 and 24 hours after operation (all P<0.05). VAS scores in the observation group were significantly lower than those in the control group while RSS scores were significantly higher than those in the control group. The dosage of sufentanil was significantly less than that in the control group at 4, 8 and 24 hours after operation (all P<0.05). The incidence rates of nausea and vomiting in the observation group (12.80% and 7.20%) were significantly lower than those in the control group (32.00% and 16.00%) (all P<0.05). Conclusion · Compared with sufentanil alone, dexmedetomidine combined with sufentanil not only can significantly enhance the analgesic and sedative effects, but also can significantly reduce the dosage of sufentanil, and reduce adverse drug reactions in PCIA of puerperae with severe preeclampsia after cesarean section.
Key words: severe preeclampsia, dexmedetomidine, sufentanil, patient-controlled intravenous analgesia


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