盐酸右美托咪定与咪达唑仑预防剖宫产术中欣母沛致恶心呕吐的比较：一项随机对照试验。
A Comparison of Dexmedetomidine and Midazolam for the Prevention of Postoperative Nausea and Vomiting Caused by Hemabate in Cesarean Delivery: A Randomized Controlled Trial.
机构信息
Department of Anesthesiology, The Affiliated Hospital of Guizhou Medical University, Guiyang,People's Republic of China.
Department of Clinical Research Centre, The Affiliated Hospital of Guizhou Medical University, Guiyang, People's Republic of China.
出版信息
Drug Des Devel Ther. 2020 May 28;14:2127-2133. doi: 10.2147/DDDT.S251525. eCollection 2020.
OBJECTIVE
To compare the efficacy of dexmedetomidine and midazolam in the prevention of postoperative nausea and vomiting (PONV) caused by hemabate in postpartum hemorrhage during cesarean delivery.
METHODS
One hundred and five parturients with American Society of Anesthesiology (ASA) physical status I and II, aged 20-40 years, undergoing elective cesarean delivery under epidural anesthesia were randomly allocated into dexmedetomidine group (group D, n=35), midazolam group (group M, n=35) and control group (group C, n=35). Patients received an intrauterine injection of 250 μg hemabate and continuous intravenous infusion of 5 units oxytocin immediately following the delivery of the infant. At the same time, patients in group D received 1μg/kg intravenous dexmedetomidine, group M received 0.02 mg/kg intravenous midazolam and group C received 20 mL intravenous saline. Parameters such as the PONV, other adverse reactions (chest distress, flush, etc.) caused by hemabate, patient satisfaction, the sedation (OAA/S) scores, and the hemodynamic parameters were recorded in both groups.
RESULTS
The PONV incidence in group D and group M was significantly lower compared with group C (6%, 17%, and 71% for group D, group M, and group C, respectively, P<0.05). The sedation (OAA/S) scores in group D and group M was significantly higher compared with group C (1.62±0.28, 1.75±0.31, and 1.00±0.00 for group D, group M, and group C, respectively, P<0.05). The patient satisfaction in group D and group M was significantly higher compared with group C (94%, 69%, and 46% for group D, group M, and group C, respectively, P<0.05). Furthermore, there were more patients satisfied with group D than group M (94% vs.69%, P<0.05).
CONCLUSION
Intravenous dexmedetomidine (1 μg/kg) and midazolam (0.02 mg/kg) were equally effective in preventing PONV introduced by hemabate and dexmedetomidine is superior to midazolam in patient satisfaction.
目的
比较右美托咪定和咪达唑仑预防剖宫产产后出血应用欣母沛（卡前列素氨丁三醇）后恶心呕吐（PONV）的效果。
方法
选择择期行剖宫产术、ASA 分级Ⅰ或Ⅱ级、年龄 20~40 岁的产妇 105 例，随机分为右美托咪定组（D 组，n=35）、咪达唑仑组（M 组，n=35）和对照组（C 组，n=35）。胎儿娩出后，三组产妇均立即宫腔内注射欣母沛 250μg，同时静脉持续泵注缩宫素 5U。D 组产妇静脉给予 1μg/kg 右美托咪定，M 组给予 0.02mg/kg 咪达唑仑，C 组给予 20mL 生理盐水。记录三组产妇术后 PONV 及欣母沛不良反应（胸闷、潮红等）发生情况、患者满意度、镇静评分（OAA/S）、血流动力学参数。
结果
D 组和 M 组 PONV 发生率明显低于 C 组（6%、17%和 71%，P<0.05），D 组和 M 组镇静评分（OAA/S）明显高于 C 组（1.62±0.28、1.75±0.31 和 1.00±0.00，P<0.05），D 组和 M 组患者满意度明显高于 C 组（94%、69%和 46%，P<0.05），且 D 组满意度明显高于 M 组（94% vs.69%，P<0.05）。
结论
剖宫产术后应用欣母沛致 PONV 时，静脉给予右美托咪定（1μg/kg）和咪达唑仑（0.02mg/kg）效果相当，且右美托咪定的患者满意度优于咪达唑仑。
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