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| 布比卡因复合右美托咪定在剖宫产术蛛网膜下腔麻醉中的安全性和有效性 |
| Safety and efficacy of bupivacaine combined with dexmedetomidine in subarachnoid anesthesia for cesarean section |
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| DOI：10.12089/jca.2019.09.013 |
| 中文关键词: 右美托咪定 布比卡因 剖宫产术 蛛网膜下腔麻醉 |
| 英文关键词: Dexmedetomidine Bupivacaine Cesarean section Subarachnoid anesthesia |
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| 中文摘要: |
目的 探讨布比卡因复合右美托咪定在剖宫产术蛛网膜下腔麻醉(腰麻)的安全性和有效性。
方法 择期腰麻下行剖宫产术的产妇150例,年龄20～35岁，体重60～85 kg,随机分为三组,B组:0.5％布比卡因9 mg;FB组:0.5％布比卡因7.5 mg+芬太尼20 μg;DB组:0.5％布比卡因7.5 mg+右美托咪定5 μg。记录产妇感觉和运动阻滞起效时间、持续时间,以及低血压、寒战、恶心呕吐等不良反应发生情况。
结果 B组、FB组和DB组感觉阻滞起效时间分别为(14.8±2.9)s、(15.5±2.2)s和(12.3±1.6)s,DB组明显短于B组和FB组,B组明显短于FB组(P<0.05)。B组、FB组和DB组感觉阻滞持续时间分别为(122.3±23.5)min、(108.7±21.4)min和(147.3±18.0)min,DB组明显长于B组和FB组,B组明显长于FB组(P<0.05)。B组、FB组和DB组运动阻滞起效时间分别为(3.4±1.1)min、(3.2±0.8)min和(2.8±0.7)min,DB组明显短于B组和FB组(P<0.05)。B组、FB组和DB组运动阻滞持续时间分别为(162.1±24.5)min、(141.3±21.9)min和(188.5±21.7)min,DB组明显长于B组和FB组,B组明显长于FB组(P<0.05)。DB组产妇低血压、寒战、术中及术后恶心呕吐的发生率均明显低于B组(P<0.05),且DB组低血压发生率明显低于FB组(P<0.05)。
结论 剖宫产术中布比卡因复合右美托咪定的腰麻效果优于复合芬太尼,且安全性更高。 |
| 英文摘要: |
Objective To explore the efficacy and safety of bupivacaine combined with dexmedetomidine in subarachnoid anesthesia for cesarean section.
Methods A total of 150 parturients, aged 20-35 years, weighing 60-85 kg, who underwent cesarean section in subarachnoid anesthesia were randomly divided into 3 groups: group B receiving 0.5％ bupivacaine 9 mg, group FB receiving 0.5％ bupivacaine 7.5 mg with fentanyl 20 μg, group DB receiving 0.5％ bupivacaine 7.5 mg with dexmedetomidine 5 μg. The onset time and duration of sensory and motor block, the incidence of hypotension, shivering, nausea, and vomiting were recorded.
Results The onset time of sensory block in groups B, FB and DB was (14.8 ± 2.9)s, (15.5 ± 2.2)s and (12.3 ± 1.6)s, respectively. The onset time of sensory block was shortened significantly in group DB than in groups B and FB (P < 0.05). The duration of sensory block in groups B, FB and DB was (122.3 ± 23.5)min, (108.7 ± 21.4)min and (147.3 ± 18.0)min, respectively. The duration of sensory block was longer in group DB than in groups B and FB (P < 0.05). The onset time of motor block in groups B, FB and DB was (3.4 ± 1.1)min, (3.2 ± 0.8)min and (2.8 ± 0.7)min, respectively. The onset time of motor block was shortened significantly in group DB than in groups B and FB (P < 0.05). The onset time of motor block in groups B, FB and DB was (162.1 ± 24.5)min, (141.3 ± 21.9)min and (188.5 ± 21.7)min, respectively. The duration of motor block was longer in group DB than in groups B and FB (P < 0.05). Compared with group B, the incidence of hypotension, shivering, nausea, and vomiting during and after operation in group DB was significantly lower (P < 0.05), while the incidence of hypotension in group DB was significantly lower than in group FB (P < 0.05).
Conclusion The effect of bupivacaine combined with dexmedetomidine is better than that of compound fentanyl on lumber anesthesia during cesarean section, and the safety is better. |
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