右美托咪定对剖宫产术后恢复质量QoR 40的影响

目的 评价右美托咪定对剖宫产术后恢复质量QoR-40的影响.方法 择期腰-硬联合麻醉下行剖宫产术初产妇80例,随机分为2组(n=40):右美托咪定组(D组)和对照组(C组).胎儿娩出断脐后,D组静脉输注右美托咪定0.75 μg/kg输注10 min后,改0.4 μg·kg-1·h-1输注20 min;C组静脉输注生理盐水30 mL.记录术后24 h QoR-40评分及术后不良反应.结果 与C组比较,D组产妇术后24 h QoR-40总分明显升高(182.3±3.6)vs(166.0±5.6),P<0.05)].D组产妇术后情绪状态、身体舒适度、心理支持和疼痛感受方面评分升高(P<0.05),而2组术后自理能力评分差别无统计学意义(P>0.05).与C组比较,D组产妇术后不良反应发生率明显降低,差别均有统计学意义(P<0.05).结论 右美托咪定可以提高剖宫产产妇术后24 h QoR-40评分,减少术后不良反应,改善术后恢复质量.

The Effect of Dexmedetomidine on the Postoperative Quality of Recovery after Caesarean Section

Objective To observe the effect of Dex on the postoperative quality of recovery after caesarean section.Methods 80 patients undergoing cesarean section under combined spinal epidural anesthesia were randomly allocated to two groups(n=40): Dex group(group D)or control group(group C).As soon as fetus was removed,0.75 μg/kg Dex were infused in group D for 10 min,then 0.4 μg·kg-1·h-1 Dex were infused for 20 min.Group C was given 30 mL 0.9％NaCl.The QoR-40 score after surgery,and side effects such as postoperative shivering,nausea and vomiting were recorded.Results Compared with group C,QoR-40 scores at 24 h after surgery was significantly increased(182.3±3.6)vs(166.0±5.6),(P<0.05)].The improvement in QoR scores reflected improvements in the dimensions of emotional status,physical comfort,psychological support,and postoperative pain(P<0.05)in group D.However,there was no significant difference in the physical independence item between group D and group C(P>0.05).Compared with group C,the incidence of postoperative shivering,nausea and vomiting in 24 h was decreased in group D(P<0.05).Conclusion The results indicate that Dex enhances the QoR-40 scores at 24 h after surgery,and alleviates postoperative side effects such as postoperative shivering,nausea and vomiting,while it improves quality of recovery.