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中国郑州某产科单位剖宫产术前及术期应用右美托咪定与常规治疗的安全性和有效性的回顾性比较。

Retrospective Comparison of the Safety and Effectiveness of Dexmedetomidine Versus Standard of Care Before and During Cesarean Delivery in a Maternity Unit in Zhengzhou, China.

机构信息

Clinical Psychiatric Nursing, School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China (mainland).

Clinical Psychiatric Nursing, School of nursing and health, Zhengzhou University, Zhengzhou, China (mainland).

出版信息

Med Sci Monit. 2020 Oct 24;26:e925709. doi: 10.12659/MSM.925709.

DOI:10.12659/MSM.925709
PMID:33097682
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7592428/
Abstract

BACKGROUND The objective of the present study was to test the hypothesis that intravenous dexmedetomidine is safe and effective when administered to women before and during cesarean section. MATERIAL AND METHODS The analysis included 392 women who received spinal anesthesia and no analgesia prior to undergoing elective cesarean delivery. Of them, 115 women received dexmedetomidine before anesthesia and during delivery (DX cohort), 109 received normal saline before anesthesia and during delivery and dexmedetomidine after delivery (SC cohort), and 168 received normal saline only before anesthesia and during delivery (CN cohort). Data about the women's consumption of sufentanil and ondansetron during hospitalization, onset of lactation, and hospital stays were retrospectively collected and analyzed. RESULTS Most of the women in the study were primiparous (362/392). The women in the DX cohort received less sufentanil during their hospital stays than those in either of the other 2 cohorts (SC comparison: 151.45±11.15 μg vs. 175.12±25.15 μg, P<0.0001, q=8.776; CN comparison: 151.45±11.15 μg vs. 185.42±37.45 μg, P<0.0001, q=13.911). Also, the women in the DX cohort received less ondansetron before discharge and had shorter times to first lactation and hospital stays than those in the SC and CN cohorts. CONCLUSIONS Administering dexmedetomidine before spinal anesthesia appears to be safe and effective for women undergoing elective cesarean delivery.

摘要

背景

本研究旨在验证在剖宫产术前和术期间静脉给予右美托咪定是否安全有效的假设。

材料与方法

该分析纳入了 392 名接受脊髓麻醉且在择期剖宫产术前未接受任何镇痛的女性。其中,115 名女性在麻醉前和分娩期间接受右美托咪定(DX 组),109 名女性在麻醉前和分娩期间接受生理盐水和分娩后接受右美托咪定(SC 组),168 名女性仅在麻醉前和分娩期间接受生理盐水(CN 组)。回顾性收集并分析了女性在住院期间舒芬太尼和昂丹司琼的消耗量、泌乳开始时间和住院时间的数据。

结果

研究中的大多数女性为初产妇(362/392)。与其他 2 组相比,DX 组女性在住院期间舒芬太尼用量较少(SC 比较:151.45±11.15μg 比 175.12±25.15μg,P<0.0001,q=8.776;CN 比较:151.45±11.15μg 比 185.42±37.45μg,P<0.0001,q=13.911)。此外,DX 组女性在出院前接受的昂丹司琼较少,首次泌乳时间和住院时间短于 SC 组和 CN 组。

结论

在脊髓麻醉前给予右美托咪定似乎对接受择期剖宫产的女性是安全有效的。

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本文引用的文献

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Drug Des Devel Ther. 2020 Mar 11;14:1083-1093. doi: 10.2147/DDDT.S241153. eCollection 2020.
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Dexmedetomidine and sufentanil combination versus sufentanil alone for postoperative intravenous patient-controlled analgesia: a systematic review and meta-analysis of randomized controlled trials.右美托咪定和舒芬太尼联合与单纯舒芬太尼用于术后静脉患者自控镇痛:随机对照试验的系统评价和荟萃分析。
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Effect of intraoperative infusion of dexmedetomidine on postoperative recovery in patients undergoing endovascular interventional therapies: A prospective, randomized, controlled trial.
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