右美托咪定辅助硬膜外神经阻滞无痛分娩的临床研究.pdf

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1、·临床麻醉·中国现代医生2014年8月第52卷第23期右美托咪定辅助硬膜外神经阻滞无痛分娩的临床研究胡慈贤任秋生王洪黄丽君周振锋宁波大学医学院附属鄞州医院宁波市鄞州人民医院麻醉科，浙江宁波315040【摘要】目的探讨右美托咪定静脉注射辅助硬膜外神经阻滞无痛分娩的有效性以及安全性。方法单胎足月产妇40例，随机分为两组。C组(n=20)：硬膜外穿刺置管注入局麻药(0．125％罗哌卡因与芬太尼1．5Ixg／mL)10mL后实施PCEA，单次剂量4mL，锁定时间15rain，背景剂量4mL／h；D组(n=20)：常规硬膜外阻滞外辅助静脉注射右美托咪定0．2g／(kg·h)。监测

2、ECG、RR、BP、SpO，视觉模拟评分评估镇痛效果并观察记录产程进展、新生儿情况及不良反应。结果第一、二产程组间VAS评分D组优于C组(P

3、etomidineintravenousassistedepiduralanesthesiaforlaboranalgesiaHUCixianRENQiushengWANGHongHUANGLijunZHOUZhenfengDepartmentofAnesthesiology，YinzhouHospitalAffiliatedtoMedicalSchoolofNingboUniversity，YinzhouPeople’SHospitalofNingboCity，Ningbo315040，China[Abstract]ObjectiveToinvestigatethee

4、fficacyandsafetyofdexmedetomidineintravenousassistedepiduralanesthe-siaforlaboranalgesia．MethodsFortyfulltermpuerperantwhohadasinglefetuswererandomlydividedintotwogroups，GroupC(n=20)，acatheterwasadvancedintoepiduralspace，anestheticdrugs(0．125％ropivacainewithfen—tanyl1．5Ixg／mL)of10mlwasin

5、fused，thenimplementPCEA(bolus4mLwith15minlockoutinterval，backgroundin—fusion4mL／h)．GroupD(n=20)assistedtheroutineepiduralblockanesthesiawithintravenousinjectionofdexmedeto．midine，whichwasinfused0．2Ixg／(kg·h)．ECG，RR，BP，SpO2，analgesiceffectwereassessedbyVAS，laborprocess，modeofdelivery，Apga

6、rscoreofneonatesandsideeffectsofanalgesiawererecorded．Resd~TheVASduringthefirstandsecondstagesoflaboringroupDwerebetterthangroupC(P<0．05)，therewasnosignificantdifferenceinAparscorebetweentwogroups．ThesecondstageoflaboringroupChadanextendedperiodoftime(P

7、nceinvitalsigns，fetalheartrateanduterinecontractionbetweentwogroups．ConclusionIntravenousdexmedetomidinecanoptimizethetraditionallaboranalgesiamodeandreducethedosageofPCEA．Thepuerperantscanbemorecomfortableandeffectiveinaccouchement．[Keywords]Dexmedetomidine：Epiduralanest