麻醉方式：腰麻用药1+1能否＞2

本文由“小麻哥的日常"授权转载

摘要译文(供参考)

布比卡因单用及与右美托咪定或哌替啶联合用于剖宫产腰麻的镇痛特点：

一项双盲随机临床试验研究

背景

通过比较布比卡因在腰麻中的佐剂，我们评估了布比卡因单独使用以及与右美托咪定或哌替啶联合使用在剖宫产腰麻中的特异性阻滞特性和不良反应。

方法

在这项双盲随机临床试验研究中，90名孕妇被分成三组，分别接受

10 mg布比卡因（B组），

10 mg布比卡因和5 μg右美托咪定（BD组），

或10 mg布比卡因和10 mg哌替啶（BM组）鞘内注射。

评估患者手术期间的镇痛质量。

使用SPSS 21分析感觉和运动阻滞的持续时间以及麻醉相关并发症，p值<0.05被认为具有统计学意义。

结果

所有治疗组的感觉和运动阻滞发作基本相同。

与B组和BM组相比，BD组的阻滞回归时间显著延长（p<0.001）。

BD和BM组的镇痛持续时间明显长于B组（p<0.001）。

BD组的镇静水平高于B组。

B组40%的患者出现颤抖，明显高于BD组（16.6%）和BM组（33.3%）。

BM组33.3%的女性出现瘙痒，在统计学上高于B组（3.33%）和BD组（0）。

所有组的不良反应发生率相同。

结论

布比卡因与右美托咪定联合使用显著延长了感觉和运动的消退时间和镇痛持续时间。

图1：

研究流程图。

图2:

（a） 收缩压；（b） 心率。

表1

人口统计学和临床特征。

表2

脊髓阻滞特征和镇静水平。

表3 

不良事件。

表4

Apgar评分和脐动脉气体分析。

原文摘要

Analgesic Characteristics of Bupivacaine Alone and in Combination with Dexmedetomidine or Meperidine in Spinal Anesthesia during Cesarean Section:

A Double-Blind Randomized Clinical Trial Study

Background

Comparing bupivacaine's adjuvants in spinal anesthesia, we assessed the specific blocking characteristics and adverse effects of bupivacaine alone and in combination with dexmedetomidine or meperidine in spinal anesthesia during cesarean section.

Methods

In this double-blind randomized clinical trial study, ninety pregnant women were divided into groups to receive 10 mg bupivacaine (group B), 10 mg bupivacaine with 5 μg dexmedetomidine (group BD), or 10 mg bupivacaine with 10 mg meperidine (group BM) intrathecal. Patients were assessed for the quality of analgesia during operations. Durations of sensory and motor blocks and anesthesia-related complications were analyzed using SPSS 21, and p values <0.05 were considered statistically significant.

Results

The onset of sensory and motor blocks was essentially the same in all treated groups. Block regression time was significantly prolonged in the BD group compared to the B and BM groups (p < 0.001). The duration of analgesia was significantly longer in the BD and BM groups than in the B group (p < 0.001). The level of sedation in the BD group was higher than in the B group. Shivering occurred in 40% of patients in the B group, which was significantly more than that of the BD (16.6%) and BM (33.3%) groups. Itching happened in 33.3% of women in the BM group which was statistically more than that of the B (3.33%) and BD (0) groups. The incidence of adverse effects was the same in all groups.

Conclusion

The combination of bupivacaine with dexmedetomidine significantly prolonged sensory and motor regression time and duration of analgesia.

Figure 1 Consort follow diagram.

Figure 2

(a) Systolic blood pressure; (b) heart rate.

Table 1

Demographic and clinical characteristics.

Table 2

Spinal block characteristics and the level of sedation.

Table 3

Adverse events.

Table 4

Apgar scores and umbilical artery gas analysis.