超前镇痛止吐对于硬膜外麻醉下子宫手术牵拉反应的临床观察

目的:探讨芬太尼复合恩丹西酮超前镇痛预防妇科手术牵拉反应的效果。方法:选择妇科子宫切除手术病人40例,随机分成I组芬太尼复合恩丹西酮20例,Ⅱ组芬太尼复合氟哌啶20例。观察用药前、探查、牵拉子宫或附件时,收缩压(SBP)、舒张压(DMP)、心率(HR)、经皮脉搏氧饱和度(SPO2)、呼吸频率(HR)以及牵拉反应情况。结果:Ⅰ、Ⅱ组病人探查牵拉子宫附件时,血压均下降(P<0.05),Ⅱ组与Ⅰ组比较牵拉时舒张压及心率下降明显(P<0.05),但探查牵拉时呼吸次数无明显差异(P>0.05),Ⅰ组与Ⅱ组比较Ⅰ组抑制牵拉反应更有效(P<0.05)。结论:芬太尼复合恩丹西酮能更有效地抑制硬膜外麻醉下的妇科手术内脏牵拉反应。

Clinical Observation of Drag Reaction in Uterus Operation when Using Advanced Analgesia and Antemetic Drugs in Epidural Anesthesia

Objective:To explore the clinical result of Ondansetron conbined with fentanyl to prevent drag reaction in gynecological operation.Method:Forty patients were divided into two groups,radomly and all patients had received Uterectomy.Ondansetron conbined with fentanyl were used in the first group and fentanyl conbined with droperidol were used in the second group.The drag reaction,SPO2,systolic pressure,diastolic pressure,respiratory rate and heart rate were observed dusing the operation.Results:The blood pressure and heart rate of the second group were decreased more than that of the first group(P<0.05).The change of respiratory rate had no significant difference daving in the opertion(P>0.05).The first group had better result than the second group in preventing the drag reaction(P<0.05).Conclusion:The clinical result shows that the Ondansetron conbined with fentanyl were more effective in preventing the drag reaction in uterus operation in epidural anesthesia.