首页|不同剂量纳布啡复合利多卡因对剖宫产产妇麻醉效果、恢复质量与应激反应的作用

不同剂量纳布啡复合利多卡因对剖宫产产妇麻醉效果、恢复质量与应激反应的作用

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目的:分析剖宫产术应用不同剂量纳布啡复合利多卡因的麻醉效果及安全性.方法:选取2021年2月-2024年4月本院住院拟剖宫产产妇82例,采用双盲法分为低剂量组与高剂量组各41例,分别采用0.1mg/kg、0.2 mg/kg纳布啡与利多卡因进行麻醉,比较两组麻醉效果[宫缩痛视觉模拟评分(VAS)与镇痛维持时间]、恢复质量(首次下床时间、肛门排气时间、泌乳始动时间及术后48h内哺乳次数)、应激反应[血清皮质醇(Cor)、去甲肾上腺素(NE)和血清酵固酮(ALD)水平]及术后并发症发生情况.结果:低剂量组苏醒期VAS评分(2.06±0.19分)低于高剂量组(3.65±0.24分),镇痛维持时间(4.15±0.41 h)高于高剂量组(3.89±0.62 h),首次下床时间(13.4±2.3h)、肛门排气时间(21.4±5.3h)、泌乳始动时间(24.4±5.4h)均短于高剂量组(14.8±3.7h、23.9±4.8h、29.5±5.8h),术后 48h 内哺乳次数(8.2±1.6次)高于高剂量组(6.4±1.5次),术后血清Cor、NE、ALD水平均低于高剂量组,并发症总发生率(14.6%)低于高剂量组(36.6%)(均P<0.05).结论:低剂量纳布啡与利多卡因用于剖宫产术中麻醉,可提升麻醉效果,加快产妇术后恢复并减轻应激反应,安全性较高.
Effects of the different doses of nalbuphine combined with lidocaine for anesthesia of women during cesarean section on their anesthetic effect,recovery quality and stress response
Objective:To analyze the anesthetic effect and safety of the different doses of nalbuphine combined with li-docaine for anesthesia of women during cesarean section.Methods:A total of 82 women who wanted cesarean section admitted to the hospital were selected and were divided into two groups by random method from February 2021 to A-pril 2024.During cesarean section,the women in group A were given 0.1mg/kg nalbuphine combined with lidocaine for anesthesia and the women in group B were given 0.2mg/kg nalbuphine combined with lidocaine for anesthesia.The an-esthesia effect evaluated by visual analogue scale(VAS)of uterine contraction pain and the analgesic duration,the quality of recovery,such as the first time of getting out of bed,the anal vent time,the lactation onset time and the number of lactation within 48h after cesarean section,the situation stress response,such as the levels of serum cortisol(Cor),norepinephrine(NE)and zymosterone,and the postoperative complication rate of the women were compared between the two groups.Results:The VAS score(2.06±0.19 points)of the women in group A was significantly lower than that(3.65±0.24 points)of the women in group B.The duration of analgesia(4.15±0.41 h)of the women in group A was significantly higher than that(3.89±0.62 h)of the women in group B.The first time of getting out of bed(13.4±2.3h),the anal exhaust time(21.4±5.3h)and the lactation start time(24.4±5.4h)of the women in group A were significantly shorter than those(14.8±3.7h,23.9±4.8h and 29.5±5.8h)of the women in group B.The number of the lactation(8.2±1.6 times)of the women in group A within 48 hours after cesarean section was significantly higher than that(6.4±1.5 times)of the women in group B.The serum levels of Cor,NE and ALD of the women in group A were significantly lower than those of the women in group B.The total incidence(14.6%)of complications of the women in group A was significantly lower than that(36.6%)of the women in group B(all P<0.05).Conclusion:The application of the low dose nalbuphine combined with the lidocaine for anesthesia of the women during cesarean section can improve the anesthetic effect,accelerate the postoperative recovery and reduce the stress response of the women,and with the higher safety.

Caesarean sectionDifferent doses of nalbuphineLidocaineAnesthetic effectStress responsePostop-erative recoveryComplication

吕晴、潘鑫、李静文

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安徽省临泉县人民医院(236400)

安徽省阜阳市人民医院

剖宫产术 不同剂量纳布啡 利多卡因 麻醉效果 应激反应 术后恢复 并发症

2024

中国计划生育学杂志
国家人口计生委科学技术研究所

中国计划生育学杂志

CSTPCD
影响因子:1.759
ISSN:1004-8189
年,卷(期):2024.32(12)