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Received:May 24, 2023 Published Online:December 21, 2024
Received:May 24, 2023 Published Online:December 21, 2024
中文摘要: 目的 探讨右美托咪定对剖宫产新生儿的安全性及产妇血流动力学和神经阻滞情况的影响。方法 回顾性分析2021年7月至2022年10月自贡市第一人民医院收治的剖宫产产妇117例的临床资料。根据麻醉前有无给予右美托咪定将产妇分为两组，未给予右美托咪定的52例为对照组，麻醉前给予右美托咪定的65例为观察组。比较两组新生儿Apgar评分、新生儿行为神经测定（NBNA）、产妇血流动力学指标、感觉和运动阻滞情况、产妇并发症发生情况。结果 两组新生儿1、5 min Apgar评分及2、4 d NBNA评分比较差异无统计学意义（P＞0.05）。输注药物后5 min（T2）、手术结束前10 min（T3）、胎儿分娩时（T4）两组产妇平均动脉压均显著低于输注药物前1 min（T1），但观察组T2~T4平均动脉压均大于对照组；T2~T4两组产妇心率均明显高于T1，但观察组T2~T4心率均低于对照组（P＜0.05），两组各时间点脉搏血氧饱和度差异无统计学意义（P＞0.05）。观察组产妇感觉阻滞起效时间及运动阻滞起效时间均较对照组更短，观察组产妇感觉阻滞持续时间及运动阻滞持续时间均较对照组更长（P＜0.05）。观察组产妇并发症总发生率低于对照组（4.62% vs 17.31%, χ2=5.056， P＝0.025）。结论 麻醉前给予右美托咪定可有提高椎管内麻醉剖宫产产妇血流动力学参数稳定性，缩短感觉及运动阻滞起效时间，延长感觉及运动阻滞持续时间，减少产妇并发症发生，且对新生儿Apgar评分、NBNA评分无显著影响，具有较高的安全性。
Abstract:Objective To investigate the effects of dexmedetomidine on the safety of newborns, and maternal hemodynamic parameters and nerve block of cesarean section. Methods The clinical data of 117 cases of cesarean section delivery admitted to the Zigong First People’s Hospital from July 2021 to October 2022 were retrospectively analyzed. The women were divided into two groups based on whether dexmedetomidine was given before anesthesia, 52 cases who were not given dexmedetomidine were divided into control group, and 65 cases who were given dexmedetomidine before anesthesia were divided into observation group. The two groups were compared with the newborn’s Apgar score, the Neonatal Behavioral Neurological Assessment (NBNA), maternal hemodynamic indicators, sensory block, motor block, and maternal complications. Results There was no significant difference in the Apgar score and the NBNA score at 2 and 4 days between the two groups of newborns (P＞0.05). Compared with 1 minute before drug infusion (T1), the mean arterial pressure in both groups was significantly reduced at 5 minutes after drug infusion (T2), 10 minutes before the end of surgery (T3), and at the time of fetal delivery (T4), and the mean arterial pressure of T2 to T4 in the observation group were higher than those of the control group. Heart rate of T2 to T4 in the observation group was significantly higher than that of T1, but the heart rate of T2 to T4 in the observation group was lower than that of the control group (P＜0.05), and there was no statistical difference in saturation of peripheral oxygen (SpO2) between the two groups at all time points (P＞0.05). The time of onset of sensory block and motion block of observation group were shorter than those of control group. The duration of sensory block and motion block of observation group were longer than those of control group (P＜0.05). The total incidence of maternal complications in the observation group was lower than that in the control group (4.62% vs 17.31%, χ2=5.056, P=0.025). Conclusion Dexmedetomidine before anesthesia can improve the stability of hemodynamics parameters, shorten the onset time of sensory and motor block, extend the duration of sensory and motor block, reduce the incidence of maternal complications, and has no significant impact on the neonatal Apgar score and NBNA score.
keywords: Dexmedetomidine Cesarean Section Apgar score Neonatal Behavioral Neurological Assessment Hemodynamics
文章编号： 中图分类号：R614.2 文献标志码：A
基金项目:四川省医学青年医学创新科研计划（S19008）；自贡市科研计划（2023YLWS17）
| Author Name | Affiliation |
| LI Wulan, WANG Jun, XU Tao, ZHOU Nina, TANG Guoqiang | Department of Anesthesiology, Zigong First People’s Hospital, Zigong, Sichuan 643000, China |
| Author Name | Affiliation |
| LI Wulan, WANG Jun, XU Tao, ZHOU Nina, TANG Guoqiang | Department of Anesthesiology, Zigong First People’s Hospital, Zigong, Sichuan 643000, China |
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