Mazy Alaa, Gad Mona, Bedairy Mohamed
Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Saudi J Anaesth. 2018 Apr-Jun;12(2):183-189. doi: 10.4103/sja.SJA_450_17.
The peritoneal wound is frequently neglected during laparotomy. The preperitoneal local anesthetics and many adjuvants were effective for postcesarean analgesia. Analgesia may involve somatic and autonomic components. The preperitoneal bupivacaine and the promising adjuvants dexamethasone or dexmedetomidine were compared in this study.
Sixty patients subjected to a cesarean section (CS) under general anesthesia divided into two groups using a bolus of preperitoneal bupivacaine 0.7 mg/kg with either 1ug/kg dexmedetomidine (Group P) or 8 mg dexamethasone (Group D). The time to the first analgesic request was the primary outcome.
There was a significantly prolonged time to the first analgesic request in the Group P than the Group D and less required preperitoneal injections in the Group P, also pain assessed by Numerical Rating Scale (NRS) was lower in the Group P than the Group D after 6 h postoperatively up to 24 h.
Dexmedetomidine provided better analgesia than dexamethasone as an adjuvant to preperitoneal bupivacaine post-CS.
剖腹手术期间腹膜伤口常被忽视。腹膜前局部麻醉药及多种佐剂对剖宫产术后镇痛有效。镇痛可能涉及躯体和自主神经成分。本研究比较了腹膜前布比卡因与有前景的佐剂地塞米松或右美托咪定。
60例行全身麻醉下剖宫产术（CS）的患者，使用0.7mg/kg腹膜前布比卡因推注，分为两组，一组加用1μg/kg右美托咪定（P组），另一组加用8mg地塞米松（D组）。首次镇痛需求时间为主要观察指标。
P组首次镇痛需求时间显著长于D组，P组腹膜前注射次数更少，且术后6小时至24小时期间，P组采用数字评分量表（NRS）评估的疼痛程度低于D组。
剖宫产术后，作为腹膜前布比卡因的佐剂，右美托咪定的镇痛效果优于地塞米松。
