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比较鞘内注射哌替啶、哌替啶-布比卡因及单纯布比卡因对择期剖宫产术后疼痛程度和血流动力学参数的影响。

Comparing the Effect of Intrathecal Injection of Meperidine, Meperidine-Bupivacaine, and Bupivacaine Alone on Pain Severity and Hemodynamic Parameters after Elective Cesarean Section.

作者信息

Zangoue Malihe, Sabertanha Amir, Younesi Zahra

机构信息

Department of Anesthesiology, School of Medicine Birjand University of Medical Sciences, Birjand, Iran.

出版信息

Anesth Pain Med. 2022 Nov 19;12(5):e117090. doi: 10.5812/aapm-117090. eCollection 2022 Oct.

Abstract

BACKGROUND

This study aimed to evaluate the effect of meperidine and bupivacaine on maternal hemodynamic changes prior to anesthesia and compare it with post-intervention.

METHODS

In this clinical trial, the rate of postoperative analgesia on 90 healthy women candidates for elective cesarean section with spinal anesthesia was evaluated by meperidine, bupivacaine, and a combination of these two drugs. The study was conducted on 90 patients, including 30 patients receiving injection of meperidine, 30 patients receiving injection of bupivacaine, and 30 patients receiving injection of meperidine plus bupivacaine. Nausea, vomiting, headache, itching, and shortness of breath were also recorded.

RESULTS

The mean systolic and diastolic blood pressure as well as heart rate and mean arterial blood pressure in the meperidine group were significantly lower than those detected before the intervention (P < 0.05). The mean SpO index was significantly decreased in meperidine and meperidine+bupivacaine groups (P < 0.05). The prevalence of nausea, vomiting and itching was higher in meperidine group compared to those in the other two groups (P = 0.032).

CONCLUSIONS

In sum, the prevalence of nausea, vomiting, and itching in the meperidine group was higher than those in the other two groups. Due to almost equal performance of meperidine and meperidine plus bupivacaine in analgesia, the stabilization of other hemodynamic indices in the meperidine plus bupivacaine group, and the decline in the prevalence of nausea, vomiting, and itching, this combination may have been a good alternative to meperidine.

摘要

背景

本研究旨在评估哌替啶和布比卡因对麻醉前产妇血流动力学变化的影响,并与干预后进行比较。

方法

在这项临床试验中,通过哌替啶、布比卡因以及这两种药物的组合,评估了90名接受脊髓麻醉的择期剖宫产健康女性候选者的术后镇痛率。该研究对90名患者进行,包括30名接受哌替啶注射的患者、30名接受布比卡因注射的患者以及30名接受哌替啶加布比卡因注射的患者。还记录了恶心、呕吐、头痛、瘙痒和呼吸急促情况。

结果

哌替啶组的平均收缩压和舒张压以及心率和平均动脉血压显著低于干预前检测值(P < 0.05)。哌替啶组和哌替啶 + 布比卡因组的平均SpO指数显著降低(P < 0.05)。与其他两组相比,哌替啶组恶心、呕吐和瘙痒的发生率更高(P = 0.032)。

结论

总之,哌替啶组恶心、呕吐和瘙痒的发生率高于其他两组。由于哌替啶和哌替啶加布比卡因在镇痛方面表现几乎相同,哌替啶加布比卡因组其他血流动力学指标稳定,且恶心、呕吐和瘙痒的发生率下降,这种组合可能是哌替啶的一个良好替代方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a3c/10016131/949c7fc64fd7/aapm-12-5-117090-i001.jpg

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