|
| 氢吗啡酮静脉自控镇痛对产妇剖宫产术后抑郁症的影响 |
| Effects of hydromorphone for patient-controlled intravenous analgesia on postpartum depression after cesarean section |
| |
| DOI：10.12089/jca.2025.11.007 |
| 中文关键词: 氢吗啡酮 产后抑郁 剖宫产术 患者自控静脉镇痛 |
| 英文关键词: Hydromorphone Postpartum depression Cesarean section Patient-controlled intravenous analgesia |
| 基金项目: |
|
| 摘要点击次数: 1241 |
| 全文下载次数: 373 |
| 中文摘要: |
目的：观察氢吗啡酮静脉自控镇痛对产妇剖宫产术后抑郁症的影响。
方法：选择2024年6—12月择期行腰-硬联合麻醉下剖宫产术的产妇87例，年龄23～36岁，BMI 24～30 kg/m2，ASA Ⅱ级，单胎足月妊娠。采用随机数字表法将产妇分为两组：舒芬太尼组（S组,n=43）与氢吗啡酮组（H组,n=44）。术毕S组和H组分别静脉注射舒芬太尼0.1 μg/kg、氢吗啡酮5 μg/kg，随后连接静脉镇痛泵。S组镇痛泵配方：舒芬太尼3 μg/kg、帕洛诺司琼4 μg/kg加生理盐水配至150 ml。H组镇痛泵配方：氢吗啡酮0.15 mg/kg、帕洛诺司琼4 μg/kg加生理盐水配至150 ml。记录术后1、6周内抑郁症的发生情况、术后24、48 h Ramsay评分、术后6、12、24、48 h静息时VAS疼痛评分、术后48 h内镇痛泵总按压次数、有效按压次数及补救镇痛情况。记录产后出血、术后48 h内恶心呕吐、头晕、嗜睡等不良反应的发生情况。
结果：与S组比较，H组术后1、6周内抑郁症发生率明显降低（P<0.05），术后24、48 h Ramsay评分明显降低（P<0.05），术后48 h内头晕与嗜睡发生率明显降低（P<0.05）。两组术后48 h内静息时VAS疼痛评分、镇痛泵总按压次数、有效按压次数、补救镇痛率以及其他不良反应差异无统计学意义。
结论：氢吗啡酮用于产妇剖宫产术后静脉自控镇痛可降低术后1、6周内抑郁症发生率，减少术后头晕与嗜睡的发生。 |
| 英文摘要: |
Objective: To observe the effects of hydromorphonein postoperative patient-controlled intravenous analgesia (PCIA) on postpartum depression after cesarean section.
Methods: Eighty-seven parturients undergoing elective cesarean section by combined spinal-epidural anesthesia from June to December 2024 were enrolled, aged 23-36 years, BMI 24-30 kg/m2, ASA physical status Ⅱ, with singleton full-term pregnancy. All the parturients were divided into two groups using a random number table method: sufentanil group (group S, n = 43) and hydromorphone group (group H, n = 44). After the operation, group S and group H were intravenously injected with sufentanil 0.1 μg/kg and hydromoradone 5 μg/kg, respectively, and then connected to intravenous analgesia pumps. The formula for the analgesic pump in group S: sufentanil 3 μg/kg, palonosetron 4 μg/kg, and normal saline mixed to 150 ml. The formula for the analgesic pump in group H: hydromorphinone 0.15 mg/kg, palonosetron 4 μg/kg, and normal saline mixed to 150 ml. The occurrence of postpartum depression within 1 and 6 weeks postoperatively, Ramsay scores at 24, and 48 hours after surgery, resting VAS pain scores at 6, 12, 24, and 48 hours after surgery, as well as the total number of presses, effective presses of the analgesia pump, and rescue analgesia administration within 48 hours after surgery were recorded. The occurrence of postpartum hemorrhage and adverse reactions such as nausea and vomiting, dizziness, and drowsiness within 48 hours postoperatively were also recorded.
Results: Compared with group S, the incidence of postpartum depression was significantly reduced in group H within 1 week and 6 weeks postoperatively (P < 0.05). Compared with group S, the Ramsay scores were also significantly lower at 24 and 48 hours postoperatively in group H (P < 0.05), and the incidence of dizziness and drowsiness within 48 hours postoperatively was significantly reduced in group H (P < 0.05). There were no significant differences between the two groups in the resting VAS score, the total number and the effective number of analgesic pump compressions, rescue situations, and other adverse reactions within 48 hours postoperatively.
Conclusion: Hydromorphone for PCIA after cesarean section in parturients can reduce the incidence of postpartum depression within 1 week and 6 weeks after operation, and decrease the occurrence of dizziness and drowsiness. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
