地佐辛复合布托啡诺在剖宫产产妇术后镇痛、镇静效果及并发症的对比分析#br#

Objective?To analyze the application effects of dezocine combined with butorphanol on postoperative analgesia, sedation and complications of puerperae with cesarean section. Methods?98 patients after cesarean section treated in the First Affiliated Hospital of Henan University of CM between October 2019 and March 2021 were selected, and randomly divided into control group (n=48, treated with butorphanol) and observation group (n=50, treated with dezocine combined with butorphanol). Visual Analogue Scale (VAS), Bruggrmann Comfort Scale (BCS) and Ramsay Sedation Score (RSS) were used to compare the analgesic effects at 1 h, 6 h, 12 h and 24 h after surgery (T1-T4). Levels of C-reactive protein (CRP), interleukin-6 (IL-6) and interleukin-2 (IL-2) of the two groups were compared at T1 and T4. Incidence rate of postoperative complications was compared between the two groups. Results?VAS scores of patients in observation group at T1-T4 were lower while BCS scores were higher compared those in control group, and Ramsay sedation scores at T1-T3 were higher than those in control group, with time-point effect, between-group effect and interaction effect (P<0.05). Levels of CRP and IL-6 of observation group at T1 and T4 were lower while level of IL-2 was higher compared to control group (P<0.05). The incidence rates of complications of the two groups were 8.00% and 16.67% respectively (P>0.05). Conclusion?Dezocine combined with butorphanol has better sedative and analgesic effects on puerperae after cesarean section, and it helps to improve the comfort and relieve the body’s inflammatory response, with few complications.     

地佐辛复合布托啡诺在剖宫产产妇术后镇痛、镇静效果及并发症的对比分析CSCD

目的 分析地佐辛复合布托啡诺在剖宫产产妇术后镇痛、镇静应用效果及并发症情况。方法 选择2019年10月至2021年3月河南中医药大学第一附属医院收治的剖宫产术后患者98例,随机将98例患者分为对照组(n=48,采用布托啡诺治疗)和观察组(n=50,采用地佐辛复合布托啡诺治疗)。使用视觉模拟评分法(VAS)和舒适评分(BCS)、Ramsay镇静评分(RSS)、对术后1、6、12、24 h(T1~T4)各时间点的镇痛效果进行对比;比较两组T1和T4时间点C反应蛋白(CRP)、白介素-6(IL-6)和白介素-2(IL-2)水平;比较两组患者术后并发症发生率。结果 观察组患者T1~T4时间点VAS评分较对照组降低且BCS评分均高于对照组,T1~T3各时间点Ramsay镇静评分均高于对照组,存在时间、组间和交互效应(P <0.05)。观察组术后T1和T4时间点CRP和IL-6均低于对照组,IL-2高于对照组(P <0.05)。两组并发症发生率分别为8.00%和16.67%,差异无统计学意义(P> 0.05)。结论 地佐辛复合布托啡诺对剖宫产产妇手术后镇静止痛效果较好,有助于提高患者舒适度,减轻机体炎性反应,且并发症较少。     

不同浓度罗哌卡因硬膜外分娩镇痛对产妇的影响

〔摘 要〕 目的：探讨不同浓度罗哌卡因硬膜外分娩镇痛对产妇的影响。 方法：回顾性选取 2019 年 1 月至 2022 年 1 月 河南中医药大学第一附属医院收治的 80 例行无痛分娩的初产妇作为研究对象。其中 34 例在硬膜外分娩镇痛应用较低浓度 的盐酸罗哌卡因，为低浓度组。46 例应用较高浓度的盐酸罗哌卡因，为高浓度组。收集产程时间、子宫收缩情况、疼痛程 度、分娩结局等临床资料。比较两组产妇第一产程、第二产程、第三产程、总产程时间；比较两组产妇镇痛前（T1）、子 宫口开大 4 cm（T2）、子宫口开全（T3）的子宫收缩的持续时间与间隔时间，及镇痛前、镇痛后 10 min、30 min、1 h 时 的视觉模拟评分法（VAS）评分。比较两组产妇产后出血量、缩宫素用量、分娩期间导尿情况、中转剖宫产率。 结果：两 组产妇的第一产程、第二产程、第三产程、总产程时间比较，差异无统计学意义（P ＞ 0.05）。子宫收缩情况统计结果显示， 低浓度组产妇 T2、T3 的持续时间长于高浓度组，差异具有统计学意义（P ＜ 0.05），间隔时间短于高浓度组，差异具有统 计学意义（P ＜ 0.05）；镇痛后 10 min、30 min、1 h，低浓度组产妇 VAS 评分高于高浓度组，差异具有统计学意义（P ＜ 0.05）。 低浓度组产妇缩宫素用量低于高浓度组，差异具有统计学意义（P ＜ 0.05）。 结论：硬膜外分娩镇痛期间使用不同浓度的 局部麻醉药物，对产妇的影响有所不同。低浓度罗哌卡因能够在保障镇痛效果的前提下，较大限度的减少对产妇的不良影响。