Mishra Prashant Kumar, Yadav Jay Brijesh Singh, Singh Arun Kumar, Singh Rakesh Bahadur
Department of Anaesthesiology, Uttar Pradesh University of Medical Sciences, Etawah, Uttar Pradesh, India.
Anesth Essays Res. 2020 Apr-Jun;14(2):219-225. doi: 10.4103/aer.AER_69_20. Epub 2020 Oct 12.
Stress response to endotracheal intubation and surgery is associated with exaggerated hemodynamic response and an increase in catecholamine levels which is deleterious to both the mother and fetus. We aimed to compare the effects of intravenous nalbuphine and paracetamol on maternal hemodynamic status, neonatal APGAR score, and postoperative pain using the visual analog scale for elective cesarean section under general anesthesia.
This was a prospective, randomized, double-blinded clinical study.
Sixty full-term pregnant patients, belonging to the American Society of Anaesthesiologist physical status Classes I and II, scheduled for elective cesarean section under general anesthesia were enrolled for the study. The patients were randomly allocated into two groups of 30 patients each to receive paracetamol (15 mg.kg) in Group Pand nalbuphine (0.2 mg.kg) in Group N before induction of general anesthesia. Maternal heart rate, blood pressure, and oxygen saturation were recorded before infusion of study drugs, after induction, after intubation, and during surgery across all periods. APGAR score of neonates was recorded by a pediatrician. Time to reach visual analogue score-1 was recorded.
Significant attenuation of maternal hemodynamic response was observed with nalbuphine compared to the paracetamol group ( < 0.05). The time to achieve visual analogue score-1 in the postoperative period was higher in the nalbuphine group. APGAR score at 1 min was significant between the groups and at 5 min, nonsignificant difference was observed ( > 0.05).
Nalbuphine and paracetamol are effective in perioperative hemodynamic stability of mother and APGAR score of neonates. However, nalbuphine had better hemodynamic stability as compared to paracetamol with a comparable APGAR score at 5 min.
气管插管和手术引起的应激反应与过度的血流动力学反应以及儿茶酚胺水平升高有关，这对母亲和胎儿均有害。我们旨在比较静脉注射纳布啡和对乙酰氨基酚对全身麻醉下择期剖宫产产妇血流动力学状态、新生儿阿氏评分及术后疼痛（采用视觉模拟评分法）的影响。
这是一项前瞻性、随机、双盲临床研究。
纳入60例足月妊娠患者，美国麻醉医师协会身体状况分级为Ⅰ级和Ⅱ级，计划在全身麻醉下进行择期剖宫产。患者随机分为两组，每组30例，在全身麻醉诱导前，P组接受对乙酰氨基酚（15mg/kg），N组接受纳布啡（0.2mg/kg）。记录所有时间段在输注研究药物前、诱导后、插管后及手术期间产妇的心率、血压和血氧饱和度。由儿科医生记录新生儿的阿氏评分。记录达到视觉模拟评分-1的时间。
与对乙酰氨基酚组相比，纳布啡组产妇血流动力学反应明显减弱（P<0.05）。纳布啡组术后达到视觉模拟评分-1的时间更长。两组间1分钟时的阿氏评分有显著差异，5分钟时差异无统计学意义（P>0.05）。
纳布啡和对乙酰氨基酚对围手术期母亲的血流动力学稳定性和新生儿阿氏评分均有效。然而，与对乙酰氨基酚相比，纳布啡具有更好的血流动力学稳定性，且5分钟时阿氏评分相当。
Zotero 插件