目的 探究在高龄剖宫产产妇中应用右美托咪定和舒芬太尼的术后镇痛效果以及对恢复质量的影响.方法 选择2023年1月至2024年3月于江苏省常州市妇幼保健院行剖宫产术的112例高龄产妇作为研究对象,根据随机数字表法为2组.对照组(n=56)产妇在术中使用舒芬太尼,观察组(n=56)产妇使用右美托咪定联合舒芬太尼.比较2组产妇术后1、6、12、24 h的疼痛视觉模拟评分法(VAS)评分;比较2组产妇在手术结束即刻、术后6、12 h应激反应指标[皮质醇(Cor)、去甲肾上腺素(NE)];比较2组产妇术后恢复指标以及不良反应.结果 2组产妇术后1、6、12、24 h的疼痛VAS评分呈现显著下降的趋势,且观察组各时间点疼痛VAS评分均低于对照组(P<0.05);观察组手术结束即刻、术后6、12 h NE、Cor均低于对照组(P<0.05);观察组产妇初次下床活动时间、初次排气时间、初次泌乳时间均低于对照组(P<0.05);观察组不良反应发生率低于对照组(P<0.05).结论 在高龄剖宫产产妇中联合使用右美托咪定和舒芬太尼,可以有效地减轻术后疼痛情况和产妇的应激反应,并提高术后恢复质量、降低不良反应发生率.
Effect of Dexmedetomidine Combined with Sufentanil on Postoperative Analgesia and Rehabilitation Quality in Elderly Women Undergoing Cesarean Section
Objective To explore the postoperative analgesic effect and rehabilitation quality of the combined ap-plication of dexmedetomidine and sufentanil in elderly women undergoing cesarean section. Methods A total of 112 el-derly women who underwent cesarean section from January 2023 to March 2024 were selected and randomly divided into two groups. The control group (56 cases) used sufentanil during surgery,and the observation group (56 cases) used dexmedetomi-dine combined with sufentanil. The Visual Analogue Scale (VAS) scores at 1 h,6 h,12 h,and 24 h after surgery were com-pared between the two groups;The stress response indexes[cortisol (Cor),norepinephrine (NE)]were measured immediately after surgery,6 h after surgery,and 12 h after surgery. The postoperative recovery indexes and adverse reactions between the two groups were compared. Results The VAS scores at 1 h,6 h,12 h,and 24 h after surgery in the observation group were significantly lower than those in the control group (P<0.05). The NE and Cor levels in the observation group immediately after surgery,as well as at 6 h and 12 h post-surgery,were lower than those in the control group,with greater reductions in maternal stress indicators observed in the observation group (P<0.05). The times to first ambulation,passing gas,and lac-tation in the observation group were all shorter than those in the control group (P<0.05). The incidence of adverse reactions in the observation group was also lower than that in the control group (P<0.05). Conclusion The combined use of dex-medetomidine and sufentanil in elderly women undergoing cesarean section is effective in reducing postoperative pain and maternal stress responses,improving recovery quality,and lowering the incidence of adverse reactions.
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