Effect of intravenous infusion of low-dose remifentanil on obese scarred uterine puerperae undergoing cesarean section under epidural anesthesia

CHEN Chang; LIU Chao; WEI Guang-le; WANG Shu; JI Lin; DAI Ti-jun

doi:10.11659/jjssx.12E023128

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Effect of intravenous infusion of low-dose remifentanil on obese scarred uterine puerperae undergoing cesarean section under epidural anesthesia

Anesthesia | 更新时间：2024-11-18

- Effect of intravenous infusion of low-dose remifentanil on obese scarred uterine puerperae undergoing cesarean section under epidural anesthesia
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 33, Issue 11, Pages: 945-948(2024)
- 作者机构：
  
  1.盐城市第三人民医院麻醉科，江苏盐城 224000
  2.徐州医科大学麻醉药理学教研室，江苏徐州 221004
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.12E023128
  CLC： R971.2
- Published：25 November 2024，
  
  Received：29 December 2023，
- 稿件说明：
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陈昌,刘超,韦广乐等.静脉泵注小剂量瑞芬太尼对硬膜外麻醉下剖宫产肥胖瘢痕子宫产妇的影响[J].局解手术学杂志,2024,33(11):945-948.

CHEN Chang,LIU Chao,WEI Guang-le,et al.Effect of intravenous infusion of low-dose remifentanil on obese scarred uterine puerperae undergoing cesarean section under epidural anesthesia[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(11):945-948.
陈昌,刘超,韦广乐等.静脉泵注小剂量瑞芬太尼对硬膜外麻醉下剖宫产肥胖瘢痕子宫产妇的影响[J].局解手术学杂志,2024,33(11):945-948. DOI： 10.11659/jjssx.12E023128.

CHEN Chang,LIU Chao,WEI Guang-le,et al.Effect of intravenous infusion of low-dose remifentanil on obese scarred uterine puerperae undergoing cesarean section under epidural anesthesia[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(11):945-948. DOI： 10.11659/jjssx.12E023128.

摘要

目的

探讨静脉泵注小剂量瑞芬太尼对硬膜外麻醉下剖宫产肥胖瘢痕子宫产妇的影响。

方法

选择87例硬膜外麻醉下行剖宫产的肥胖瘢痕子宫产妇为研究对象，随机分为常规组（

=43）和瑞芬组（

=44）。自切皮前开始，常规组和瑞芬组产妇分别静脉泵注生理盐水、小剂量瑞芬太尼至手术结束，对比2组产妇在术中不同时点的生命体征、疼痛及舒适度评分、术中并发症情况、娩出的新生儿情况。

结果

在取胎儿时和腹腔探查时，瑞芬组产妇的心率、平均动脉压和疼痛评分均低于常规组，差异有统计学意义（

0.05）；瑞芬组产妇的术中舒适度评分高于常规组，差异有统计学意义（

0.05）。瑞芬组产妇恶心呕吐发生率低于常规组，差异有统计学意义（

0.05）。2组产妇娩出的新生儿在出生1 min和5 min时的Apgar评分、需行初步复苏新生儿和脐静脉血pH值差异均无统计学意义（

0.05）。

结论

静脉泵注0.05 μg·kg

-1

·min

-1

的小剂量瑞芬太尼，不仅可以显著降低硬膜外麻醉下剖宫产肥胖瘢痕子宫产妇的术中疼痛程度，提高术中舒适度，还有利于降低术中不良反应发生率，且可保证母婴安全。

Abstract

Objective

To investigate the effect of intravenous infusion of low-dose remifentanil on obese scarred uterine puerperae undergoing cesarean section under epidural anesthesia.

Methods

A total of 87 obese scarred uterine puerperae undergoing cesarean section under epidural anesthesia were selected as the study subjects，and they were randomly divided into the conventional group （

=43） and the remifentanil group （

=44）.From the beginning of skin incision， puerperae of the conventional group and the remifentanil group were intravenously injected with normal saline and low-dose remifentanil respectively until the end of the operation.The vital signs， pain and comfort scores， intraoperative complications of puerperae， and status of newborns were compared between the two groups at different points during the operation.

Results

During fetal extraction and peritoneal exploration，the heart rate，mean arterial pressure and pain scores of puerperae in the remifentanil group were lower than those in the conventional group，and the differences were statistically significant （

0.05）； the intraoperative comfort score of puerperae in the remifentanil group was higher than that in the conventional group，and the difference was statistically significant （

0.05）.The incidence of nausea and vomiting of puerperae in the remifentanil group was lower than that in the conventional group，and the difference was statistically significant （

0.05）.There was no significant difference in the Apgar score at 1 minute and 5 minutes after delivery，requiring initial resuscitation or pH value of umbilical vein blood between newborns delivered by puerperae of t

he two groups （

0.05）.

Conclusion

Intravenous infusion of 0.05 μg·kg

-1

·min

-1

low-dose remifentanil not only significantly reduces intraoperative pain and improves comfort of obese scarred uterine puerperae undergoing cesarean section under epidural anesthesia， but also helps to reduce the incidence of adverse reactions and ensure maternal and infant safety.

关键词

硬膜外麻醉瑞芬太尼肥胖瘢痕子宫剖宫产

Keywords

epidural anesthesiaremifentanilobesityscarred uterinecesarean section

references

陈晓，何慧娅，吴建妙.孕早期超声所示胎盘位置对剖宫产后再生育妇女妊娠结局的影响［J］.生殖医学杂志，2023，32（11）：1750-1752.doi：10.3969/j.issn.1004-3845.2023.11.023http://dx.doi.org/10.3969/j.issn.1004-3845.2023.11.023.

程贤鹦，张朋辉，王园园，等.三孩产妇的妊娠特征和分娩方式及围生儿结局的研究［J］.中国计划生育学杂志，2023，31（11）：2544-2549.doi：10.3969/j.issn.1004-8189.2023.11.004http://dx.doi.org/10.3969/j.issn.1004-8189.2023.11.004.

代振兴，朱非洲，李井华，等.不同穿刺间隙腰硬联合麻醉对剖宫产产妇血液动力学、牵拉反应及新生儿的影响［J］.临床和实验医学杂志，2021，20（5）：532-535.doi：10.3969/j.issn.1671-4695. 2021.05.023http://dx.doi.org/10.3969/j.issn.1671-4695.2021.05.023.

黄玉惠，李永优，王燕.右美托咪定对剖宫产产妇血流动力学、牵拉反应及新生儿的影响［J］.中国药物与临床，2020，20（10）：1650-1652.doi：10.11655/zgywylc2020.10.027http://dx.doi.org/10.11655/zgywylc2020.10.027.

郜宗斌，杨光，施舟，等.阿芬太尼对腰-硬联合麻醉剖宫产术中牵拉痛及寒战的影响［J］.中华全科医学，2023，21（11）：1865-1867.doi：10.16766/j.cnki.issn.1674-4152.003244http://dx.doi.org/10.16766/j.cnki.issn.1674-4152.003244.

Zhang X，Wang J，An XH，et al.Optimum dose of spinal ropivacaine with or without single intravenous bolus of S-ketamine during elective cesarean delivery：a randomized，double-blind，sequential dose-finding study［J］.BMC Pregnancy Childbirth，2021，21（1）：746.doi：10.1186/s12884-021-04229-yhttp://dx.doi.org/10.1186/s12884-021-04229-y.

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，aprospective，randomized study［J］.BMC Anesthesiol，2019，19（1）：243-249.doi：10.1186/s12871-019-0900-xhttp://dx.doi.org/10.1186/s12871-019-0900-x.

吴昊，石军，况雪静.两点法腰麻-硬膜外联合麻醉在剖宫产手术中的麻醉效果及安全性［J］.川北医学院学报，2022，37（8）：1050-1054.doi：10.3969/j.issn.1005-3697.2022.08.020http://dx.doi.org/10.3969/j.issn.1005-3697.2022.08.020.

Guasch E，Brogly N，Gilsanz F.Combined spinal epidural for labour analgesia and caesarean section：indications and recommendations［J］.Curr Opin Anaesthesiol，2020，33（3）：284-290.doi：10.1097/ACO. 0000000000000866http://dx.doi.org/10.1097/ACO.0000000000000866.

Chooi C，Cox JJ，Lumb RS，et al.Techniques for preventing hypotension during spinal anaesthesia for caesarean section［J］.Cochrane Database Syst Rev，2020，7（7）：CD002251.doi：10.1002/14651858.CD002251http://dx.doi.org/10.1002/14651858.CD002251.

杨铎，张隆盛，黄熙扬，等.小剂量艾司氯胺酮防治剖宫产术中寒战及牵拉反应的有效性与安全性分析［J］.现代医院，2023，23（10）：1600-1604.doi：10.3969/j.issn.1671-332X.2023.10.035http://dx.doi.org/10.3969/j.issn.1671-332X.2023.10.035.

李艳，孙静，鲁瑶.小剂量舒芬太尼复合布比卡因麻醉对初产妇剖宫产术中内脏牵拉反应及寒战发生率的影响［J］.山西医药，2020，49（16）：2167-2169.doi：10.3969/j.issn.0253-9926. 2020.16.031http://dx.doi.org/10.3969/j.issn.0253-9926.2020.16.031.

周林杰，屈献锋，杨礼，等.不同剂量布托啡诺输注对瘢痕妊娠剖宫产患者术后镇痛效果和牵拉反应的影响［J］.中国妇幼保健，2022，37（15）：2775-2778.doi：10.19829/j.zgfybj.issn.1001-4411.2022.15.017http://dx.doi.org/10.19829/j.zgfybj.issn.1001-4411.2022.15.017.

孙红，吴岚，杨利利，等.罗哌卡因和布比卡因用于剖宫产腰硬联合麻醉术中防治牵拉反应效果的比较［J］.北京医学，2019，41（8）：687-689.doi：10.15932/j.0253-9713.2019.08.018http://dx.doi.org/10.15932/j.0253-9713.2019.08.018.

魏天祺，冯珍.迷走神经电刺激临床应用及机制研究进展［J］.中国康复医学杂志，2015，30（2）：185-188.doi：10.3969/j.issn. 1001-1242.2015.02.021http://dx.doi.org/10.3969/j.issn.1001-1242.2015.02.021.

吴宏彦，蒋留琴，南帅.瑞芬太尼在腰硬联合麻醉剖宫产手术中的应用效果及对产妇血流动力学与应激反应的影响［J］.临床医学研究与实践，2023，8（6）：87-89.doi：10.19347/j.cnki.2096-1413.202306026http://dx.doi.org/10.19347/j.cnki.2096-1413.202306026.

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