摘要
目的探讨曲马多联合布托啡诺对重复剖宫产女性子宫痉挛性疼痛的镇痛作用及其有效性和安全性。方法选择2022年9月至2023年4月在惠州市第一妇幼保健院进行2次或以上剖宫产的118例经产妇作为研究对象。根据电脑随机数表法将产妇分为舒芬太尼组(58例)和曲马多联合布托啡诺组(60例),记录两组产妇剖宫产术后6、12、24、48 h的子宫痉挛性疼痛和腹部切口疼痛的静息、运动疼痛数字评分法(NRS)评分;采用匹兹堡睡眠质量指数(PSQI)评估两组产妇手术当天和术后第1天的睡眠质量;记录两组产妇术后瘙痒、恶心、呕吐、呼吸抑制等不良事件发生情况;记录两组术后镇痛补救例数。结果在6、12、24 h时间点,曲马多联合布托啡诺组经产妇子宫痉挛性疼痛的静息、运动NRS评分均低于舒芬太尼组,差异有统计学意义(P<0.05);两组经产妇在任何时间点的腹部切口疼痛的静息、运动NRS评分比较,差异无统计学意义(P>0.05);曲马多联合布托啡诺组经产妇在手术当天和术后第1天的PSQI评分明显低于舒芬太尼组,差异有统计学意义(P<0.05);两组不良事件总发生率和镇痛补救率比较,差异无统计学意义(P>0.05)。结论曲马多联合布托啡诺在剖宫产术后镇痛管理中展现出良好的应用前景,特别是在早期子宫痉挛性疼痛的镇痛效果和改善睡眠质量方面具有显著优势。
Objective Exploring the analgesic effect,efficacy,and safety of tramadol combined with butorphanol on uterine spasmodic pain in women undergoing repeated cesarean section.Methods A total of 118 multiparous women who underwent two or more cesarean sections at Huizhou First Maternal and Child Health Care Hospital from September 2022 to April 2023 were selected as the study subjects.According to the computer random number table method,the parturients were divided into the sufentanil group(58 cases)and the tramadol combined with butorphanol group(60 cases).The resting and motor numerical pain rating scale(NRS)scores of uterine spasticity pain and abdominal incision pain were recorded for both groups of parturients at 6,12,24,and 48 h after cesarean section.The Pittsburgh sleep quality index(PSQI)was used to evaluate the sleep quality of two groups of parturients on the day of surgery and the first day after surgery.Record the occurrence of adverse events such as itching,nausea,vomiting,and respiratory depression in two groups of postpartum women after surgery.Record the number of postoperative pain relief cases in two groups.Results The resting and motor NRS scores of transwomen with uterine spasmodic pain in the tramadol combined with butorphanol group were lower than those of the sufentanil group at the 6,12,and 24 h time points,and the difference was statistically significant(P<0.05).The comparison of resting and motor NRS scores of transwomen with abdominal incisional pain in the two groups at any time point were not statistically significant(P>0.05).The PSQI scores of transwomen on the day of surgery and postoperative day 1 in the tramadol combined with butorphanol group were lower than those of the sufentanil group,and the difference was statistically significant(P<0.05).The total incidence of adverse events and analgesic remediation rate of the two groups were compared,and the difference was not statistically significant(P>0.05).Conclusion The combination of tramadol and butorphanol has shown promising application prospects in postoperative pain management after cesarean section,especially in the analgesic effect of early uterine spasmodic pain and the improvement of sleep quality.
作者
朱思佳
周新春
黎冰
ZHU Sijia;ZHOU Xinchun;LI Bing(Department of Anesthesiology,Huizhou First Maternal and Child Health Care Hospital,Guangdong,Huizhou 516001,China)
出处
《中国医药科学》
2025年第2期53-56,共4页
China Medicine And Pharmacy
基金
广东省惠州市医疗卫生领域科技计划项目(2022CZ010177)。
关键词
曲马多
布托啡诺
静脉自控镇痛
子宫痉挛性疼痛
Tramadol
Butorphanol
Patient-controlled intravenous analgesia
Uterine spasmodic pain
