鞘内注射右美托咪定用于轻度子痫前期产妇剖宫产的临床观察

目的评价小剂量盐酸右美托咪定鞘内注射对轻度子痫前期产妇剖宫产的影响。方法择期腰麻下行剖宫产手术的轻度子痫前期产妇90例,ASAⅡ或Ⅲ级,随机均分为右美托咪定组(D组)和生理盐水对照组(N组)。腰麻后D组鞘内注射右美托咪定5μg,N组给予等容量的生理盐水。记录阻滞起效时间和持续时间,Richmond躁动镇静(RASS)评分;观察并记录术中及术后寒战、恶心呕吐等不良反应情况。结果与N组比较,D组感觉阻滞起效时间缩短、持续时间延长(P<0.05),运动阻滞持续时间延长(P<0.05)。N组术中出现寒战14例,明显多于D组的6例(P<0.05)。结论 0.5%布比卡因腰麻复合右美托咪定5μg鞘内注射麻醉效果要好于单纯腰麻,但国内临床应用时仍须谨慎。

Clinical observation of intrathecal dexmedetomidine in mild preeclampsia parturient undergoing cesarean section

Objective To evaluate the effect of intrathecal injection of small-dose dexmedetomidine hydrochloride in the mild preeclampsia parturient undergoing cesarean section.Methods Ninety ASA Ⅱ or Ⅲ mild preeclampsia parturients scheduled for elective cesarean section under spinal anesthesia,were randomly divided into 2 groups(n=45 each):dexmedetomidine group(group D)and normal saline group(group N).After spinal anesthesia,dexmedetomidine 5 μg was injected intrathecally in group D,while group N received the same volume of normal saline.The block onset time and duration,Richmond Agitation-Sedation Scale(RASS) were recorded.Shivering,nausea,vomiting and other adverse effects during intra-operation and post-operation were also recorded.Results Compared with group N,the sensory block onset time was shorter and the block duration was longer in group D(P<0.05).There were 14 cases of intraoperative shivering in group N,which was significantly more than those 6 cases in group D(P<0.05).Conclusion Intrathecal injection of dexmedetomidine 5 μg combined with 0.5% bupivacaine is better than bupivacaine alone in spinal anesthesia,but its clinical application must still be cautious.