小剂量硫酸镁联合舒芬太尼用于剖宫产术后镇痛效果分析
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摘要
目的探索硫酸镁联合舒芬太尼用于剖宫产术后镇痛的临床效果。方法选取本院100例剖宫产产妇,收治时间均集中在2014年8月至2016年8月期间,并对此次研究产妇进行动态随机化分为2组,每组50例产妇,对照组采用舒芬太尼麻醉,观察组采用硫酸镁联合舒芬太尼麻醉,对比两组产妇疼痛评分、Ramsay评分、BCS评分、血清镁离子浓度、血清钙离子浓度。结果观察组术后2、6、24、48hRamsay评分分别为(3.25±1.85)分、(2.14±1.47)分、(1.69±1.85)分、(1.36±1.47)分均低于对照组的(5.36±1.98)、(4.14±1.42)、(4.15±1.47)、(3.14±1.25)分,差异显著(P<0.05);观察组术后2、6、24、48h疼痛评分分别为(4.15±1.47)分、(3.47±1.20)分、(1.24±1.14)分、(0.47±0.12)分均低于对照组的(6.41±1.75)分、(4.21±1.57)分、(3.14±1.25)分及(1.14±1.47)分,差异显著(P<0.05);观察组术后6、24、48hBCS评分分别为(2.51±0.64)分、(3.55±0.54)分、(3.52±0.48)分显著高于对照组的(1.89±0.46)分、(2.61±0.35)分及(2.88±0.65)分,差异显著(P<0.05);观察组患者血清镁离子浓度(1.58±0.34)mmol/L、血清钙离子浓度(1.98±1.57)mmol/L均高于对照组的(0.36±0.45)mmol/L及(1.23±0.02)mmol/L,差异显著(P<0.05)。结论硫酸镁联合舒芬太尼可有效改善剖宫产术后疼痛严重程度。
Objective To explore the clinical efficacy of magnesium sulfate combined with sufentanil for analgesia after cesarean section.Methods A total of 100 cases of cesarean section performed in our hospital during Aug.2014 and Aug.2016 were randomly divided into 2 groups:control group(n=50)was anesthetized with sufentanil,and the observation group(n =50)was anesthetized with magnesium sulfate and sufentanil.The maternal pain score, Ramsay score, BCS score,serum magnesium ion concentration and serum calcium concentration were compared.Results The Ramsay score was(3.25±1.85),(2.14±1.47),(1.69±1.85)and(1.36±1.47)respectively in the observation group 2,6,24 and 48 hours after operation,while it was(5.36±1.98),(4.14±1.42),(4.15±1.47)and(3.14±1.25)in the control group,with significant differences between the two groups(P<0.05).The pain score of the observation group was(4.15±1.47),(3.47±1.20),(1.24±1.14)and(0.47±0.12),significantly lower than that in the control group(6.41±1.75),(4.21±1.57),(3.14±1.25),and(1.14±1.47)(P<0.05).The BCS score was(2.51±0.64),(3.55±0.54)and(3.52±0.48)in the observation group6,24 and 48 hours after the operation,significantly higher than that in the control group(1.89±0.46),(2.61±0.35),and(2.88±0.65)(P<0.05).The serum magnesium and calcium concentrations were(1.58±0.34)and(1.98±1.57)mmol/L in the observation group,significantly higher than that in the control group,(0.36±0.45)and(1.23±0.02)mmol/L(P <0.05).Conclusion Magnesium sulfate combined with sufentanil can relieve the pain after cesarean section.
Objective To explore the clinical efficacy of magnesium sulfate combined with sufentanil for analgesia after cesarean section.Methods A total of 100 cases of cesarean section performed in our hospital during Aug.2014 and Aug.2016 were randomly divided into 2 groups:control group(n=50)was anesthetized with sufentanil,and the observation group(n =50)was anesthetized with magnesium sulfate and sufentanil.The maternal pain score, Ramsay score, BCS score,serum magnesium ion concentration and serum calcium concentration were compared.Results The Ramsay score was(3.25±1.85),(2.14±1.47),(1.69±1.85)and(1.36±1.47)respectively in the observation group 2,6,24 and 48 hours after operation,while it was(5.36±1.98),(4.14±1.42),(4.15±1.47)and(3.14±1.25)in the control group,with significant differences between the two groups(P<0.05).The pain score of the observation group was(4.15±1.47),(3.47±1.20),(1.24±1.14)and(0.47±0.12),significantly lower than that in the control group(6.41±1.75),(4.21±1.57),(3.14±1.25),and(1.14±1.47)(P<0.05).The BCS score was(2.51±0.64),(3.55±0.54)and(3.52±0.48)in the observation group6,24 and 48 hours after the operation,significantly higher than that in the control group(1.89±0.46),(2.61±0.35),and(2.88±0.65)(P<0.05).The serum magnesium and calcium concentrations were(1.58±0.34)and(1.98±1.57)mmol/L in the observation group,significantly higher than that in the control group,(0.36±0.45)and(1.23±0.02)mmol/L(P <0.05).Conclusion Magnesium sulfate combined with sufentanil can relieve the pain after cesarean section.
引文
[1]邢祖民,张忠其,张伟山,等.不同镇痛方法对剖宫产产妇血清白细胞介素-6、10影响的比较[J].广东医学,2014,35(6):893-895.
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[5]周雁,敦元莉,林惠华,等.剖宫产术后用超声引导下双侧腹横肌平面阻滞联合非甾类抗炎药的镇痛效果观察[J].中国医刊,2013,48(8):79-81.
[6]马奕,董坚君,李盛,等.镇痛泵镇痛对剖宫产术后肠道功能恢复的影响[J].西南国防医药,2016,26(2):193-194.
[7]吕德荣,张景晖.舒芬太尼联合右美托咪定对腹腔镜手术患者术后镇痛效果的观察[J].国外医学(医学地理分册),2016,37(2):149-152.
[8]蒋焕伟,徐世元,方曼菁,等.硬膜外罗哌卡因复合舒芬太尼或芬太尼用于潜伏期分娩镇痛[J].临床麻醉学杂志,2015,31(3):221-223.
[9]尉明洋,胡弘毅,王培松,等.不同浓度罗哌卡因复合舒芬太尼用于剖宫产术后镇痛的临床研究[J].浙江中医药大学学报,2011,35(4):504-505.
[10]周据津,董铁立.纳布啡用于剖宫产术后镇痛的临床效果[J].江苏医药,2017,43(3):184-186.
[11]姜景卫,鲁华荣,李亭,等.复诺昔康复合不同剂量舒芬太尼用于剖宫产术后镇痛疗效观察[J].海峡药学,2012,24(8):177-178.
[12]郑建宇,唐群杰,黄广用.盐酸左布比卡因与不同质量浓度枸橼酸舒芬太尼联合用于剖宫产术后自控硬膜外镇痛的疗效观察[J].中国医院用药评价与分析,2015,15(7):898-901.
[13]利莉,陈静,覃怡,等.小剂量硫酸镁超前镇痛在剖宫产手术中的应用[J].广西医科大学学报,2009,26(5):744-746.
[14]王建.电子镇痛泵输注舒芬太尼联合阿扎司琼用于剖宫产术后镇痛的效果[J].现代中西医结合杂志,2014,23(32):3612-3613.
[15]向军,徐建武,李元涛,等.硫酸镁对子痫前期重度产妇剖宫产术后镇痛效果的影响[J].中国当代医药,2015,22(15):43-46.
[16]李九会,郭荣,李寿,等.舒芬太尼联合地佐辛用于剖宫产术后镇痛的疗效及对患者血清泌乳素水平的影响[J].现代生物医学进展,2016,16(25):4873-4875.
[17]刘艾竹,关雷,盛崴宣.氟比洛芬酯联合不同剂量舒芬太尼用于改良悬雍垂腭咽成形术后镇痛[J].中国微创外科杂志,2016,16(4):351-354.
[18]张萱.硫酸镁用于剖宫产术后硬膜外镇痛效果观察[J].中国误诊学杂志,2012,12(6):1285-1287.
[19]马开喜,张鹏,王绍林,等.不同剂量舒芬太尼鞘内注射对剖宫产术后镇痛效果的影响[J].淮海医药,2011,29(2):118-119.
[20]卢静,兰志勋,蔡兵,等.地佐辛联合舒芬太尼用于剖宫产术后自控静脉镇痛效果观察[J].四川医学,2013,34(10):1507-1509.
[2]谢海,李艳.超声引导下不同入路腹横肌平面阻滞对剖宫产手术后镇痛的影响[J].首都医科大学学报,2015,36(5):791-793.
[3]苗茜,闵苏,魏珂,等.罗哌卡因、左旋布比卡因复合芬太尼用于剖宫产术后镇痛半数有效浓度的研究[J].重庆医学,2011,40(30):3073-3075.
[4]杨欢欢,韩蓓,刘孟文,等.渭南市2013年孕妇碘营养状况监测分析[J].国外医学(医学地理分册),2015,12(3):202-204.
[5]周雁,敦元莉,林惠华,等.剖宫产术后用超声引导下双侧腹横肌平面阻滞联合非甾类抗炎药的镇痛效果观察[J].中国医刊,2013,48(8):79-81.
[6]马奕,董坚君,李盛,等.镇痛泵镇痛对剖宫产术后肠道功能恢复的影响[J].西南国防医药,2016,26(2):193-194.
[7]吕德荣,张景晖.舒芬太尼联合右美托咪定对腹腔镜手术患者术后镇痛效果的观察[J].国外医学(医学地理分册),2016,37(2):149-152.
[8]蒋焕伟,徐世元,方曼菁,等.硬膜外罗哌卡因复合舒芬太尼或芬太尼用于潜伏期分娩镇痛[J].临床麻醉学杂志,2015,31(3):221-223.
[9]尉明洋,胡弘毅,王培松,等.不同浓度罗哌卡因复合舒芬太尼用于剖宫产术后镇痛的临床研究[J].浙江中医药大学学报,2011,35(4):504-505.
[10]周据津,董铁立.纳布啡用于剖宫产术后镇痛的临床效果[J].江苏医药,2017,43(3):184-186.
[11]姜景卫,鲁华荣,李亭,等.复诺昔康复合不同剂量舒芬太尼用于剖宫产术后镇痛疗效观察[J].海峡药学,2012,24(8):177-178.
[12]郑建宇,唐群杰,黄广用.盐酸左布比卡因与不同质量浓度枸橼酸舒芬太尼联合用于剖宫产术后自控硬膜外镇痛的疗效观察[J].中国医院用药评价与分析,2015,15(7):898-901.
[13]利莉,陈静,覃怡,等.小剂量硫酸镁超前镇痛在剖宫产手术中的应用[J].广西医科大学学报,2009,26(5):744-746.
[14]王建.电子镇痛泵输注舒芬太尼联合阿扎司琼用于剖宫产术后镇痛的效果[J].现代中西医结合杂志,2014,23(32):3612-3613.
[15]向军,徐建武,李元涛,等.硫酸镁对子痫前期重度产妇剖宫产术后镇痛效果的影响[J].中国当代医药,2015,22(15):43-46.
[16]李九会,郭荣,李寿,等.舒芬太尼联合地佐辛用于剖宫产术后镇痛的疗效及对患者血清泌乳素水平的影响[J].现代生物医学进展,2016,16(25):4873-4875.
[17]刘艾竹,关雷,盛崴宣.氟比洛芬酯联合不同剂量舒芬太尼用于改良悬雍垂腭咽成形术后镇痛[J].中国微创外科杂志,2016,16(4):351-354.
[18]张萱.硫酸镁用于剖宫产术后硬膜外镇痛效果观察[J].中国误诊学杂志,2012,12(6):1285-1287.
[19]马开喜,张鹏,王绍林,等.不同剂量舒芬太尼鞘内注射对剖宫产术后镇痛效果的影响[J].淮海医药,2011,29(2):118-119.
[20]卢静,兰志勋,蔡兵,等.地佐辛联合舒芬太尼用于剖宫产术后自控静脉镇痛效果观察[J].四川医学,2013,34(10):1507-1509.