本文選題：氯普魯卡因 + 嗎啡　； 參考：《中國(guó)臨床藥理學(xué)雜志》2017年02期

【摘要】：目的觀察氯普魯卡因聯(lián)合嗎啡硬膜外麻醉對(duì)剖宮產(chǎn)術(shù)后鎮(zhèn)痛效果及其對(duì)炎癥因子的影響。方法將150例進(jìn)行剖宮產(chǎn)的產(chǎn)婦隨機(jī)分為A組50例、B組50例及C組50例。3組患者均進(jìn)行腰硬聯(lián)合麻醉,并于腰麻后55 min注射嗎啡2 mg。A組于注射嗎啡前10 min靜脈注射3%氯普魯卡因5 mL,B組于注射嗎啡后10 min靜脈注射3%氯普魯卡因5 mL,C組于注射嗎啡前10 min靜脈注射0.9%NaCl 5 mL。比較3組產(chǎn)婦的體征情況、手術(shù)時(shí)間、麻醉藥物用量、圍術(shù)期炎癥因子、術(shù)后疼痛視覺(jué)模擬量表(VAS)評(píng)分變化,以及藥物不良反應(yīng)的發(fā)生情況。結(jié)果術(shù)后4 h,A、B、C組的疼痛視覺(jué)模擬評(píng)分分別為(3.17±0.26),(1.95±0.28),(2.04±0.31)分,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。A、B、C組的手術(shù)時(shí)間分別為(48.26±7.91),(48.85±7.64),(49.13±7.52)min,差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。A、B、C組的舒芬太尼用量分別為(44.26±8.15),(31.06±7.21),(35.84±9.13)μg,B組與A、C組比較差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。術(shù)后12 h,A、B、C組的白細(xì)胞介素-2(IL-2)分別為(1.57±0.58),(2.31±0.65),(2.07±0.46)pg·L~(-1);IL-6分別為(143.29±15.81),(120.26±18.91),(133.08±16.51)pg·L~(-1);IL-10分別為(106.24±8.63),(78.20±7.64),(83.96±7.85)pg·mL~(-1);腫瘤壞死因子-α分別為(171.80±18.36),(97.30±26.13),(149.21±24.41)pg·L~(-1),差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。3組產(chǎn)婦的藥物不良反應(yīng)均為皮膚瘙癢和嘔吐,且A、B、C組產(chǎn)婦的藥物不良反應(yīng)發(fā)生率分別為36.00%,30.00%,34.00%,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論硬膜外依次注射嗎啡、氯普魯卡因,能夠起到良好的鎮(zhèn)痛效果,降低產(chǎn)婦舒芬太尼使用量,并能夠維持炎性因子平衡,減輕術(shù)后炎癥反應(yīng)。
[Abstract]:Objective to observe the analgesic effect of chloroprocaine combined with morphine epidural anesthesia on postoperative analgesia of cesarean section and its effect on inflammatory factors. Methods 150 cases of parturient undergoing cesarean section were randomly divided into group A (n = 50) and group C (n = 50) under combined spinal-epidural anesthesia. The rats in group B were injected with 3% chloroprocaine 5 mL / L 10 min before morphine injection, and group C was injected with 3% chloroprocaine 5 mL / L 10 min after morphine injection. 0.9%NaCl 5 mL was injected 10 min before morphine injection in group C (n = 10). The changes of physical signs, operation time, dosage of anesthetic drugs, perioperative inflammatory factors, postoperative pain visual analogue scale (VAS) scores and adverse drug reactions were compared among the three groups. Results the visual analogue scores of pain in group C were 3.17 鹵0.26, 1.95 鹵0.28 and 2.04 鹵0.31, respectively. The time of operation was 48.26 鹵7.91, 48.85 鹵7.64, 49.13 鹵7.52 min, respectively. There was no significant difference in the dosage of sufentanil between the two groups (44.26 鹵8.15, 31.06 鹵7.21, 35.84 鹵9.13) 渭 g / min, respectively. 鏈悗12 h,A,B,C緇勭殑鐧界粏鑳?yōu)浠嬬矗?

本文編號(hào)：1940688