静脉输注右美托咪定联合规律性间断硬膜外注射分娩镇痛疗效分析被引量：30

Analysis the Efficacy of Intravenous Dexmedetomidine Combined with Regular Intermittent Epidural Bolus During Labor Analgesia

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摘要目的:探讨静脉输注右美托咪定联合规律性间断硬膜外注射用于分娩镇痛的安全性及可行性。方法:选择2014年7～12月在我院产科接受硬膜外分娩镇痛的初产妇100例,随机分为两组:规律性间断硬膜外注射组(对照组)和右美托咪定联合规律性间断硬膜外注射组(右美托咪定组),每组50例。比较两组分娩镇痛期间生命体征的变化、分娩镇痛时间(T0～T4时)、第二产程时间、硬膜外药物消耗量、分娩方式、新生儿Apgar评分、镇痛前及镇痛后血浆儿茶酚胺的变化。结果:1两组产妇分娩镇痛期间平均动脉压(MBP)、视觉模拟评分(VAS)组间比较,差异无统计学意义(P>0.05);虽然右美托咪定组在T2和T4时的心率低于对照组(P<0.05),但在正常范围内。两组产妇分娩镇痛时间、分娩方式及新生儿Apgar评分比较,差异均无统计学意义(P>0.05)。2右美托咪定组较对照组第二产程时间更短、硬膜外药物消耗量更少(P<0.05)。3两组产妇实施分娩镇痛后血浆肾上腺素及去甲肾上腺素均明显下降,右美托咪定组下降幅度明显高于对照组(P<0.05)。结论:静脉输注右美托咪定联合规律性间断硬膜外注射可安全及有效地应用于分娩镇痛,并能增强镇痛效能及利于阴道分娩。 Objective： To investigate the safety and feasibility of intravenous dexmedetomidine combined with regular intermittent epidural bolus（ RIEB） during labor analgesia. Methods： From July to Dec. 2014,100 primiparaes were choosen and randomly assigned into the dexmedetomidine combined with RIEB group（ dexmedetomidine group） and RIEB group（ control group）,each group had 50 cases. The vital sign during labor analgesia,the duration of labor analgesia（ from T0 to T4） and second stage of labor,the consumption of epidural drugs,the mode of delivery,the Apgar scores of neonates,the plasma catecholamine value before and during labor analgesia were compared between two groups. Results： 1There was no significant difference in MBP and VAS scores,labor analgesia duration,mode of delivery and the Apgar score of neonates between two groups（ P〉 0. 05）. The heart rate was significant lower in the dexmedetomidine group than in the control group during labor analgesia in T2 and T4（ P〈 0. 05）. 2The consumption of epidural drugs and the duration of second stage of labor were significant less in the dexmedetomidine group than in the control group（ P〈 0. 05）. 3The plasma catecholamine value was significantly decreased during labor analgesia in both groups,and the decreasing rate was higher in the dexmedetomidine group（ P〈 0. 05）. Conclusions： Intravenous dexmedetomidine combined with regular intermittent epidural bolus during labor analgesia was safe and effective,it also can enhance anagesia and be benefit to vaginal delivery.

作者关正刘琳官彬刘丹申新

机构地区西安交通大学第一附属医院

出处《实用妇产科杂志》 CAS CSCD 北大核心 2016年第3期225-228,共4页 Journal of Practical Obstetrics and Gynecology

关键词规律性间断硬膜外注射右美托咪定分娩镇痛 Regular intermittent epidural bolus Dexmedetomidine Labor analgesia

分类号 R614 [医药卫生—麻醉学]

作者简介通讯作者：申新，Email：shenxinmzk@126．com

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