不同剂量羟考酮防治二次剖宫产术中牵拉反应的效果

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摘要目的评估不同剂量羟考酮防治二次剖宫产术中牵拉反应的效果。方法选取2019年10月—2020年12月于南京市妇幼保健院行择期连续硬膜外麻醉下二次剖宫产的120 例产妇作为研究对象，根据随机数字表法将其分为O1、O2、O3 与C 组，每组各30 例。胎儿娩出后，O1、O2、O3 组产妇分别给予盐酸羟考酮注射液0.08、0.10、0.12 mg/kg 静脉缓慢推入，C 组产妇给予相同剂量的生理盐水。比较三组产妇的术中牵拉反应分级、入室时（T0）、给药前（T1）、给药后10 min（T2）和探查腹腔时（T3）、术毕（T4）的平均动脉压（MAP）、心率（HR）、脉搏氧饱和度（SpO2）以及T1、T2、T3、T4 时的Ramsay 评分。结果 O2、O3 组产妇的牵拉反应分级低于C 组，差异有统计学意义（P<0.05）；O1 组产妇的牵拉反应分级与C 组比较，差异无统计学意义（P>0.05）。O1、O2、O3、C 组产妇T0、T1、T2、T3、T4 各时间点的MAP、HR 比较，差异均无统计学意义（P>0.05）。O3 组产妇T2、T3、T4 时刻的SpO2 低于O1、O2、C 组，差异有统计学意义（P<0.05）。O1、O2、O3、C 组产妇T1 时刻的Ramsay 镇静评分比较，差异无统计学意义（P>0.05）；O2、O3 组产妇T2、T3、T4 时刻的Ramsay 镇静评分高于O1、C 组，差异有统计学意义（P<0.05）。结论二次剖宫产术中静脉使用盐酸羟考酮可以为手术提供良好的镇静效果，并减轻牵拉反应的程度，且在胎儿娩出后给予产妇0.10 mg/kg 盐酸羟考酮可以提供良好的镇静效果并充分抑制术中牵拉痛，使产妇的生命体征更加平稳。

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	钱夏丽
	陈雅洁

关键词 ：二次剖宫产, 连续硬膜外麻醉, 羟考酮, 牵拉反应, 镇静

Abstract：Objective To evaluate the effect of different doses of Oxycodone in the treatment of traction reaction during second cesarean section.Methods One hundred and twenty multiparas who underwent second cesarean section in Nanjing Maternity Child Health Care Hospital from October 2019 to December 2020 were selected as the research objects.According to the random number table method,they were divided into O1,O2,O3 and C groups,with 30 cases in each group.After the fetus was delivered,group O1,O2,and O3 were given Oxycodone Hydrochloride Injection 0.08,0.10,0.12 mg/kg,respectively.Group C was given the same dose of normal saline.The mean arterial pressure(MAP),heart rate(HR),saturation of pulse oximetry(SpO2)in the entering the room(T0),before administration(T1),10 min after administration(T2),when exploring the abdominal cavity(T3),and after operation(T4),Ramsay scores at T1,T2,T3 and T4 were compared among the three groups.Results The grading of the pull reaction in groups O2 and O3 were lower than that of the group C,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the grading of traction response between group O1 and group C(P>0.05).There were no statistically significant differences in MAP and HR at T0,T1,T2,T3 and T4 among group O1,O2,O3 and C(P>0.05).The SpO2 level of group O3 was lower than that of group O1,O2 and C at T2,T3 and T4,and the differences were statistically significant(P<0.05).At T1,there was no statistically significant difference in Ramsay scores among the group O1,O2,O3 and C(P>0.05).The Ramsay scores in groups O2 and O3 were higher than those in groups O1 and C at T2,T3 and T4,and the differences were statistically significant(P<0.05).Conclusion After the fetus was delivered,Oxycodone Hydrochloride Injection can provide good sedative and relieve the visceral traction response during the secondary cesarean section.Beyond that,0.10 mg/kg Oxycodone Hydrochloride Injection provides good sedative effect,fully inhibit the visceral traction response,and stabilize maternal vital signs.

Key words： Second cesarean section Continuous epidural anesthesia Oxycodone Visceral traction response Sedative

引用本文:

钱夏丽；陈雅洁. 不同剂量羟考酮防治二次剖宫产术中牵拉反应的效果[J]. 中国当代医药, 2021, 28(25): 128-131.
QIAN Xia-li ；CHEN Ya-jie. Effect of different doses of Oxycodone in the treatment of traction reaction during the second cesarean section. 中国当代医药, 2021, 28(25): 128-131.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2021/V28/I25/128

[1]	Nanji JA，Carvalho B.Pain management during labor and vaginal birth[J].Best Pract Res Clin Obstet Gynaecol，2020，67：100-112.
[2]	俞陈陈，赵丽，吴方圆，等.盐酸羟考酮在剖宫产术中的临床应用[J].中国医师杂志，2017，19（7）：1099-1101.
[3]	Ramsay MA，Savege TM，Simpson BR，et al.Controlled sedation with alphaxalone-alphadolone[J].Bri Med J，1974，2（5920）：656-657.
[4]	韩传宝，蒋秀红，吴霞，等.右美托咪啶复合罗哌卡因硬膜外麻醉在剖宫产患者中的应用[J].中华医学杂志，2014，94（44）：3501-3505.
[5]	孙燕，韩丽莹，郭华峰，等.盐酸羟考酮复合氟比洛芬酯用于二次剖宫产术后镇痛及安全性分析[J].中国地方病防治杂志，2017，32（11）：1271.
[8]	贺端端，张华，张江超，等.不同麻醉方案椎管内麻醉用于剖宫产手术的比较研究[J].中国微创外科杂志，2020，20（1）：4-9.
[12]	Kalso E.Oxycodone[J].Pain Symptom Manage，2005，29（5）：S47-S56.
[14]	杨颖，李国芸，李辞妹.羟考酮静脉自控镇痛用于腹腔镜下宫颈癌根治术患者的效果评价[J].实用医院临床杂志，2020，17（4）：172-175.
[16]	徐建国.盐酸羟考酮的药理学和临床应用[J].临床麻醉学杂志，2014，30（5）：511-513.
[6]	Bi YH，Wu JM，Zhang YZ，et al.Effect of Different Doses of Intrathecal Dexmedetomidine as an Adjuvant Combined With Hyperbaric Ropivacaine in Patients Undergoing Cesarean Section[J].Front Pharmacol，2020，11：342.
[7]	Lu Q，Dong CS，Yu JM，et al.The dose response of sufentanil as an adjuvant to ropivacaine in cesarean section for relief from somato-visceral pain under epidural anesthesia in parturients with scarred uterus[J].Medicine（Baltimore），2018，97（38）：e12404.
[9]	Hong JY，Jee YS，Jeong HJ，et al.Effects of Epidural Fentanyl on Speed and Quality of Block for Emergency Cesarean Section in Extending Continuous Epidural Labor Analgesia Using Ropivacaine and Fentanyl[J].J Korean Med Sci，2010，25（2）：287-292.
[10]	Yan W，Xiong Y，Yao Y，et al.Continuous intravenous infusion of remifentanil improves the experience of parturient undergoing repeated cesarean section under epidural anesthesia，a prospective，randomized study[J].BMC Anesthesiol，2019，19（1）：243-250.
[11]	Collins D，Zhang Y，Blendy J，et al.Murine model of OPRM1 A118G alters oxycodone self-administration and locomotor activation，but not conditioned place preference[J].Neuropharmacology，2020，167：107864.
[13]	Olczak B，Kowalski G，Leppert W，et al.Analgesic efficacy，adverse effects，and safety of xycodone administered as continuous intravenous infusion in patients after total hip arthroplasty[J].J Pain Res，2017，10：1027-1032.
[15]	Park KB，Ann J，Lee H.Effects of different dosages of oxycodone and fentanyl on the hemodynamic changes during intubation[J].Saudi Med J，2016，37（8）：847-852.
[17]	Daouphars M，Hervouёt CH，Bohn P，et al.Physicochemical stability of oxycodone-ketamine solutions in polypropylene syringe and polyvinyl chloride bag for patient-controlled analgesia use[J].Eur J Hosp Pharm，2018，25（4）：214-217.
[18]	Kinnunen M，Piirainen P，Kokki H，et al.Updated Clinical Pharmacokinetics and Pharmacodynamics of Oxycodone[J].Clin Pharmacokinet，2019，58（6）：705-725.