中国当代医药
中國噹代醫藥
중국당대의약
PERSON
2015年
12期
78-80
,共3页
分娩镇痛%硬腰联合麻醉%舒芬太尼%最小有效剂量%不良反应
分娩鎮痛%硬腰聯閤痳醉%舒芬太尼%最小有效劑量%不良反應
분면진통%경요연합마취%서분태니%최소유효제량%불량반응
Labor analgesia%Spinal and epidural anesthesia%Sufentanil%Minimum effective dose%Adverse reactions
目的:探讨不同剂量舒芬太尼在硬腰联合麻醉分娩镇痛中的临床效果。方法选取2012年6月~2014年6月在本院分娩的96例足月妊娠初产妇为研究对象,所有患者均行硬腰联合麻醉穿刺,并在蛛网膜下腔分别注射不同剂量舒芬太尼,根据舒芬太尼的剂量不同随机分为A组(3μg,n=32)、B组(5μg,n=32)和C组(7μg,n=32)。比较各组的镇痛起效时间以及镇痛开始后10、30、60 min的视觉模拟评分(VAS)、产程、术中出血量和新生儿Apgar评分,并记录用药过程中的不良反应。结果 C组的镇痛起效时间明显短于A、B组,3组间差异有统计学意义(F=5.385,P<0.05),组间两两比较差异有统计学意义(P<0.05);镇痛作用起效后10、30、60 min时的VAS评分3组间差异有统计学意义(F值分别为4.674、7.474、5.753,均P<0.05),组间两两比较,B、C组均明显小于A组(均P<0.05),但B、C组间差异无统计学意义(P>0.05)。3组间产程、术中出血量和新生儿Apgar评分差异无统计学意义(F值分别为0.636、0.462、0.637,均P>0.05)。 B、C组的不良反应发生率明显高于A组,差异有统计学意义(χ2=5.637,P<0.05)。结论结合镇痛效果以及不良反应发生情况,舒芬太尼用于硬腰联合麻醉分娩镇痛的最小有效剂量宜选择5μg。
目的:探討不同劑量舒芬太尼在硬腰聯閤痳醉分娩鎮痛中的臨床效果。方法選取2012年6月~2014年6月在本院分娩的96例足月妊娠初產婦為研究對象,所有患者均行硬腰聯閤痳醉穿刺,併在蛛網膜下腔分彆註射不同劑量舒芬太尼,根據舒芬太尼的劑量不同隨機分為A組(3μg,n=32)、B組(5μg,n=32)和C組(7μg,n=32)。比較各組的鎮痛起效時間以及鎮痛開始後10、30、60 min的視覺模擬評分(VAS)、產程、術中齣血量和新生兒Apgar評分,併記錄用藥過程中的不良反應。結果 C組的鎮痛起效時間明顯短于A、B組,3組間差異有統計學意義(F=5.385,P<0.05),組間兩兩比較差異有統計學意義(P<0.05);鎮痛作用起效後10、30、60 min時的VAS評分3組間差異有統計學意義(F值分彆為4.674、7.474、5.753,均P<0.05),組間兩兩比較,B、C組均明顯小于A組(均P<0.05),但B、C組間差異無統計學意義(P>0.05)。3組間產程、術中齣血量和新生兒Apgar評分差異無統計學意義(F值分彆為0.636、0.462、0.637,均P>0.05)。 B、C組的不良反應髮生率明顯高于A組,差異有統計學意義(χ2=5.637,P<0.05)。結論結閤鎮痛效果以及不良反應髮生情況,舒芬太尼用于硬腰聯閤痳醉分娩鎮痛的最小有效劑量宜選擇5μg。
목적:탐토불동제량서분태니재경요연합마취분면진통중적림상효과。방법선취2012년6월~2014년6월재본원분면적96례족월임신초산부위연구대상,소유환자균행경요연합마취천자,병재주망막하강분별주사불동제량서분태니,근거서분태니적제량불동수궤분위A조(3μg,n=32)、B조(5μg,n=32)화C조(7μg,n=32)。비교각조적진통기효시간이급진통개시후10、30、60 min적시각모의평분(VAS)、산정、술중출혈량화신생인Apgar평분,병기록용약과정중적불량반응。결과 C조적진통기효시간명현단우A、B조,3조간차이유통계학의의(F=5.385,P<0.05),조간량량비교차이유통계학의의(P<0.05);진통작용기효후10、30、60 min시적VAS평분3조간차이유통계학의의(F치분별위4.674、7.474、5.753,균P<0.05),조간량량비교,B、C조균명현소우A조(균P<0.05),단B、C조간차이무통계학의의(P>0.05)。3조간산정、술중출혈량화신생인Apgar평분차이무통계학의의(F치분별위0.636、0.462、0.637,균P>0.05)。 B、C조적불량반응발생솔명현고우A조,차이유통계학의의(χ2=5.637,P<0.05)。결론결합진통효과이급불량반응발생정황,서분태니용우경요연합마취분면진통적최소유효제량의선택5μg。
Objective To discuss the clinical effect of different doses of sufentanil on labor analgesia in spinal and epidural anesthesia. Methods 96 cases of primipara with full-term pregnancy in our hospital from June 2012 to June 2014 were selected,all were taken with spinal and epidural anesthesia,and were injected different doses of sufentanil.All patient were divided into group A (3μg,n=32),group B (5μg,n=32) and group C (7 μg,n=32) according to the doses of sufentanil.The analgetic beginning time,visual analogue scale (VAS) of 10 min,30 min and 60 min after analgetic begin-ning,labor,intraoperative blood loss,neonatal Apgar score and drug adverse reactions of three groups was recorded and compared. Results The analgetic beginning time of group C was shorter than that of group A and group B (F=5.385,P<0.05),while palrwise comparison between groups had significant difference (P<0.05).There was significant difference about VAS of 10 min,30 min and 60 min after analgetic beginning among three groups (F value was 4.674,7.474 and 5.753 respectively,all P<0.05);while group B and group C was lower than that of group A (P<0.05),but there was no sig-nificant difference between group B and group C (P>0.05).There were no significant difference about labor,intraopera-tive blood loss and neonatal Apgar scores among three groups (F value was 0.636,0.462 and 0.637 respectively,all P>0.05).The incidence of drug adverse reactions of group B and group C was higher than that of group A,the difference was significant (χ2=5.637,P<0.05). Conclusion Taking into account of analgesic effect and drug adverse reactions,5μg of sufentanil is the minimum effective dose to apply combined spinal epidural anesthesia about labor analgesia.