A Comparison of Dexmedetomidine and Midazolam for the Prevention of Postoperative Nausea and Vomiting Caused by Hemabate in Cesarean Delivery: A Randomized Controlled Trial
将ASA分级为I/II级，年龄20～40岁，硬膜外麻醉下行择期剖宫产的产妇105例，随机分为右美托咪定组（D组，n=35）、咪达唑仑组（M组，n=35）和对照组（C组，n=35）。胎儿娩出后立即宫内注射250 μg欣母沛，并持续静脉滴注缩宫素5个单位。同时D组静脉给予1μg/kg右美托咪啶，M组给予咪达唑仑0.02 mg/kg，C组给予生理盐水20mL。记录PONV、欣母沛引起的其他不良反应(胸闷、潮红等)、患者满意度、镇静评分(OAA/S)和血流动力学参数。
D组和M组PONV发生率明显低于C组（D组、M组和C组分别为6%、17%和71%，P<0.05）。D组和M组的镇静评分（OAA/S）明显高于C组（D组、M组和C组分别为1.62±0.28、1.75±0.31和1.00±0.00，P<0.05）。D组和M组患者满意度显著高于C组（D组、M组和C组分别为94%、69%和46%，P<0.05）。D组患者的满意度高于M组（94% vs 69%，P<0.05）。
Hu B, Zhou H, Zou X, et al. A Comparison of Dexmedetomidine and Midazolam for the Prevention of Postoperative Nausea and Vomiting Caused by Hemabate in Cesarean Delivery: A Randomized Controlled Trial.[J].Drug Des Devel Ther, 2020, 14: 2127-2133.
Objective: To compare the efficacy of dexmedetomidine and midazolam in the prevention of postoperative nausea and vomiting (PONV) caused by hemabate in postpartum hemorrhage during cesarean delivery.
Methods: One hundred and five parturients with American Society of Anesthesiology(ASA) physical status I and II, aged 20–40 years, undergoing elective cesarean delivery under epidural anesthesia were randomly allocated into dexmedetomidine group (group D, n=35), midazolam group (group M, n=35) and control group (group C, n=35). Patients received an intrauterine injection of 250 μg hemabate and continuous intravenous infusion of 5 units oxytocin immediately following the delivery of the infant. At the same time, patients in group D received 1μg/kg intravenous dexmedetomidine, group M received 0.02 mg/kg intravenous midazolam and group C received 20 mL intravenous saline. Parameters such as the PONV, other adverse reactions (chest distress, flush, etc.) caused by hemabate, patient satisfaction, the sedation (OAA/S) scores, and the hemodynamic parameters were recorded in both groups.
Results: The PONV incidence in group D and group M was significantly lower compared with group C (6%, 17%, and 71% for group D, group M, and group C, respectively, P<0.05).The sedation (OAA/S) scores in group D and group M was significantly higher compared with group C (1.62±0.28, 1.75±0.31, and 1.00±0.00 for group D, group M, and group C, respectively, P<0.05). The patient satisfaction in group D and group M was significantly higher compared with group C (94%, 69%, and 46% for group D, group M, and group C, respectively, P<0.05). Furthermore, there were more patients satisfied with group D than group M (94% vs.69%, P<0.05).
Conclusion: Intravenous dexmedetomidine (1 μg/kg) and midazolam (0.02 mg/kg) were equally effective in preventing PONV introduced by hemabate and dexmedetomidine is superior to midazolam in patient satisfaction.
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