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右美托咪定与芬太尼作为 5%利多卡因辅助药物用于择期剖宫产女性脊髓麻醉的比较。

Comparison of Dexmedetomidine and Fentanyl as an Adjuvant to Lidocaine 5% for Spinal Anesthesia in Women Candidate for Elective Caesarean.

作者信息

Kamali Alireza, Azadfar Ronak, Pazuki Shirin, Shokrpour Maryam

机构信息

Department of Anesthesiology, Arak University of Medical Sciences, Arak, Iran.

Arak University of Medical Sciences, Arak, Iran.

出版信息

Open Access Maced J Med Sci. 2018 Oct 23;6(10):1862-1867. doi: 10.3889/oamjms.2018.365. eCollection 2018 Oct 25.

Abstract

AIM

This study aimed to compare the effect of Dexmedetomidine and fentanyl as an adjuvant to lidocaine 5% in spinal anaesthesia to increase post-operative analgesia among women candidates for elective caesarean.

METHODS

Eighty-four pregnant women candidates for caesarian were randomly divided into fentanyl and Dexmedetomidine groups. In the first group, 25 μg fentanyl was added to lidocaine 5% while in the second group, 0.5 μg per kilogram Dexmedetomidine was added to lidocaine 5%. After the operation, a pain score of the patients in recovery and within 4, 12 and 24 hours after the operation, the average length of analgesia and the average amount of the analgesics taken within 24 hours and after the operation were recorded.

RESULTS

The average length of postoperative anaesthesia and the average amount of the drug taken within the first 24 hours after the operation in fentanyl group was more than the Dexmedetomidine group (P = 0.01). Shivering in Dexmedetomidine group was more common than what was observed in the fentanyl group (P = 0.001). Higher rates of nausea-vomiting were observed in the fentanyl group (P = 0.001).

CONCLUSIONS

Fentanyl results in a longer period of postoperative analgesia and less consumption of drugs after the operation. Fentanyl is recommended in caesarian.

摘要

目的

本研究旨在比较右美托咪定和芬太尼作为5%利多卡因脊髓麻醉辅助用药,对择期剖宫产女性术后镇痛效果的影响。

方法

84例拟行剖宫产的孕妇被随机分为芬太尼组和右美托咪定组。第一组在5%利多卡因中加入25μg芬太尼,第二组在5%利多卡因中加入每千克0.5μg右美托咪定。术后记录患者恢复时、术后4小时、12小时和24小时的疼痛评分、平均镇痛时长以及术后24小时内服用的镇痛药物平均剂量。

结果

芬太尼组术后麻醉平均时长和术后24小时内服用的药物平均剂量均高于右美托咪定组(P = 0.01)。右美托咪定组寒战比芬太尼组更常见(P = 0.001)。芬太尼组恶心呕吐发生率更高(P = 0.001)。

结论

芬太尼可使术后镇痛时间更长,术后药物消耗量更少。剖宫产推荐使用芬太尼。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a4e/6236048/fbcd42e0a41e/OAMJMS-6-1862-g002.jpg

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