地佐辛复合舒芬太尼在腰硬联合麻醉剖宫产术后镇痛中的应用效果

目的 探讨地佐辛复合舒芬太尼在腰硬联合麻醉剖宫产术后镇痛中的应用效果,以为剖宫产术后麻醉药物的合理选择提供参考.方法 选取2018年10月至2019年10月收治的130例腰硬联合麻醉剖宫产术产妇作为研究对象,以随机数字表法将其分为对照组和观察组,各65例.两组均行剖宫产术,对照组采用舒芬太尼进行术后镇痛,观察组采用地佐辛复合舒芬太尼进行术后镇痛.比较两组的麻醉效果.结果 观察组术后4、12、24 h的VAS评分低于对照组,RSS评分高于对照组(P<0.05).术前,两组的NE、Cor、ET-1水平无明显差异(P>0.05);术后24 h,观察组的NE、Cor、ET-1水平低于对照组(P<0.05).观察组的初乳时间早于对照组,术后4、12、24 h的PRL水平高于对照组(P<0.05).术前,两组的NPY、SP、β-EP水平无明显差异(P>0.05);术后24 h,观察组的NPY、SP、β-EP水平低于对照组(P<0.05).结论 地佐辛复合舒芬太尼应用在腰硬联合麻醉剖宫产术后有助于提高镇痛、镇静效果,减轻产妇的应激反应,改善早期泌乳情况,下调神经递质水平,值得临床推广和应用.

Application effect of dezocine combined with sufentanil on postoperative analgesia of cesarean section under combined spinal epidural anesthesia

Objective To investigate the application effect of dezocine combined with sufentanil on postoperative analgesia of cesarean section under combined spinal epidural anesthesia,so as to provide reference for the rational selection of anesthetic drug after cesarean section.Methods A total of 130 parturient with cesarean section under combined spinal epidural anesthesia admitted from October 2018 to October 2019 were selected as the research objects.The parturient were divided into control group and observation group by random number table method,with 65 cases in each group.Both groups underwent cesarean section.The control group used sufentanil for postoperative analgesia and the observation group used dezocine combined with sufentanil for postoperative analgesia.The anesthetic effects of the two groups were compared.Results The VAS score of the observation group at 4,12 and 24 h after operation was lower than that of the control group,and the RSS score was higher than that of the control group(P<0.05).Before operation,there were no significant differences in the levels of NE,Cor and ET-1 between the two groups(P>0.05);at 24 h after operation,the levels of NE,Cor and ET-1 in the observation group were lower than those in the control group(P<0.05).The colostrum time in the observation group was earlier than that in the control group,and the PRL level at 4,12 and 24 h after operation was higher than that in the control group(P<0.05).Before operation,there were no significant differences in the levels of NPY,SP andβ-EP between the two groups(P>0.05);at 24 h after operation,the levels of NPY,SP andβ-EP in the observation group were lower than those in the control group(P<0.05).Conclusion The dezocine combined with sufentanil applied after cesarean section under combined spinal epidural anesthesia is helpful to improve the analgesic and sedative effects,reduce stress response of parturient,improve early lactation condition and reduce the levels of neurotransmitters,which is worthy of clinical promotion and application.