对比顺序和混合注射阿片类药物和高压布皮瓦卡因用于下段剖腹产时的副arachnoid 阻塞:一个随机对照研究
Moustafa M I Moustafa1, Mohamed S Ali2, Conan McCaul3,4
1Mater Misericordiae University Hospital, Tandy's Lane, eircode K78V1W3, Dublin, Ireland. ghalahmm@yahoo.com.
Irish journal of medical science
|April 11, 2024
概括
在剖腹产时分别注射甲内阿片类药物和高压布皮瓦卡因,导致更大的血动力学不稳定性,但更好地缓解疼痛. 在预混合和单独注射组之间,块特征和患者满意度仍然相似.
科学领域:
- 麻醉学 麻醉学
- 产科麻醉 产科麻醉 产科麻醉
- 药理学 药理学是指药理学的学科.
背景情况:
- 在剖腹产期间,阿片类药物经常与局部麻醉剂相结合,用于宫下关节阻塞,这是由于协同效应.
- 阿片类药物的物理化学特性可能会影响它们在脑脊液 (CSF) 中的分布,当与高压布皮瓦卡因预混合时.
- 这项研究研究了单独注射与单一混合布皮瓦卡因,吗啡和芬太尼对阻塞特征和母亲结果的影响.
研究的目的:
- 为了比较预混合与顺序注射的内阿片类药物和高压布皮瓦卡因在剖腹产时的作用.
- 为了评估两种施用方法之间的区块特征,血液动力学稳定性,术后疼痛和患者满意度的差异.
- 确定在产科麻醉中与局部麻醉剂一起给药输入管内阿片类药物的最佳方法.
主要方法:
- 一项前性,双盲,随机对照试验,涉及126名接受剖腹产的患者.
- 患者被随机分配,接受单一混合物 (M组) 或单独注射 (S组) 的高压布皮瓦卡因,芬太尼和吗啡.
- 测量包括血液动力学参数,感觉和运动阻断的进展,术后疼痛 (视觉模拟量表) 和患者满意度.
主要成果:
- 两组都表现出相似的块高度,最大感官块的时间和块回归.
- 与预混合组 (7.78%) (P=0.0002) 相比,单独注射组 (12.05%) 的系统性低血压更频繁.
- 单独注射组需要更多的乙 (12.09毫克 vs. 9.09毫克) 并报告了较低的术后疼痛得分 (VAS 3.8 vs. 4.6) (P=0.017).
结论:
- 连续注射阿片类药物和高压布皮瓦卡因导致更大的早期血液动力学不稳定性.
- 与单一预混合注射相比,单独注射提供了稍微更好的术后止痛.
- 两种施用技术之间在块高度或患者满意度上没有显著差异.
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