右美托咪定在减少剖宫产后不良反应中的作用
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Effects of dexmedetomidine in reducing post-cesarean adverse reactions
背景与目的：本研究的目的是评估右美托咪定（Dex）对剖宫产后疼痛的控制和不良反应的影响。
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方法：共纳入80名采用腰硬联合麻醉的产妇，随机分为试验组（D组）和对照组（C组）（n=40）。其中，D组采用的麻醉药物为盐酸罗哌卡因联合右美托咪定；C组采用的麻醉药物为盐酸罗哌卡因联合吗啡。随后分别于2,6,12以及24h时采用Ramsay镇静评分和视觉模拟评分（VAS）评估了镇静情况，静息和咳嗽状态的镇痛情况和药物使用相关的不良反应。
结果：除剖宫产后2h外，其余时点静息和咳嗽状态D组的VAS评分均低于C组（P＜0.05）；剖宫产后12h时D组的Ramsay镇静评分低于C组（P＜0.05），其余时点两组的Ramsay镇静评分无差异；D组恶心，呕吐以及瘙痒的发生率均显著低于C组（P＜0.05）。
结论：剖宫产中右美托咪定（Dex）的使用可提高局部麻醉方式的镇痛效果，增强腰硬联合麻醉产后的镇静作用和减少剖宫产后药物使用的不良反应发生率。
Mo Y, Qiu S. Effects of dexmedetomidine in reducing post-cesarean adverse reactions.[J]. Experimental and therapeutic medicine, 2017,14(3):2036-2039. DOI:10.3892/etm.2017.4759
BACKGROUND：This study evaluated the analgesia effect and the effect on adverse reaction of using dexmedetomidine (Dex) in post-cesarean section.
METHODS: Eighty women who had been performed caesarean delivery with combined spinal and epidural anesthesia were selected. The experimental group (group D) included 40 random patients and the control group (group C) included the other 40 women. Patients in group D were given ropivacaine hydrochloride and Dex while patients in group C were given ropivacaine hydrochloride and morphine. We assessed and recorded the patient status at 2, 6, 12, 24 and 48 h using Ramsay sedation scale and visual analogue scale (VAS) in resting state and coughing state and we also recorded their adverse reactions.
Results:Except for the first 2 h after surgery, group D gets a lower VAS score than group C all the time in either resting state or coughing state (p<0.05); at 12 h, group D had a lower Ramsay score than group C (p<0.05) and no significant difference during the rest of the time was found; group D had a significantly lower rate of nausea, emesis and pruritus than group C (p<0.05).
Conclusion:In conclusion, the usage of Dex in analgesia for post-cesarean can increase the analgesia effect produced by local anesthetics, increase puerpera sedation scores and decrease adverse reactions.
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