Application of ropivacaine combination with dexmedetomidine in opioid-free analgesia after cesarean section

LIU Kunshan; LI Mengdi; ZHAO Jianjun; CHENG Xinqi

doi:10.6039/j.issn.1001-0408.2023.01.16

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Application of ropivacaine combination with dexmedetomidine in opioid-free analgesia after cesarean section

更新时间：2025-09-26

- Application of ropivacaine combination with dexmedetomidine in opioid-free analgesia after cesarean section
- ZHONGGUO YAOFANG Vol. 34, Issue 1, Pages: 82-85(2023)
- 作者机构：
  
  1.临泉县人民医院麻醉科，安徽临泉　236400
  2.安徽医科大学第一附属医院麻醉科，合肥　230022
- 作者简介：
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2023.01.16
  CLC： R971⁺.2
- Received：06 June 2022，
  
  Revised：2022-12-17，
  
  Published：15 January 2023
- 稿件说明：
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刘坤山,李孟迪,赵建军,等.罗哌卡因联合右美托咪定在剖宫产术后去阿片化镇痛中的应用[J].中国药房,2023,34(01):82-85.

LIU Kunshan,LI Mengdi,ZHAO Jianjun,et al.Application of ropivacaine combination with dexmedetomidine in opioid-free analgesia after cesarean section[J].ZHONGGUO YAOFANG,2023,34(01):82-85.
刘坤山,李孟迪,赵建军,等.罗哌卡因联合右美托咪定在剖宫产术后去阿片化镇痛中的应用[J].中国药房,2023,34(01):82-85. DOI： 10.6039/j.issn.1001-0408.2023.01.16.

LIU Kunshan,LI Mengdi,ZHAO Jianjun,et al.Application of ropivacaine combination with dexmedetomidine in opioid-free analgesia after cesarean section[J].ZHONGGUO YAOFANG,2023,34(01):82-85. DOI： 10.6039/j.issn.1001-0408.2023.01.16.

摘要

目的

考察罗哌卡因联合右美托咪定对剖宫产产妇的术后镇痛效果，探讨腰硬联合麻醉下剖宫产术后去阿片化镇痛模式的可行性。

方法

80例剖宫产产妇随机分为观察组（采用罗哌卡因联合右美托咪定镇痛）和对照组（采用罗哌卡因联合阿片类药物舒芬太尼镇痛）各40例。比较两组产妇术后48 h内视觉模拟评分（VAS）中的运动评分和静息评分、镇痛泵使用情况（首次镇痛泵按压时间、术后24 h内和48 h内镇痛泵按压次数）、阻滞时效（腰麻感觉阻滞起效时间、腰麻感觉阻滞达最高平面的时间、感觉恢复时间和运动恢复时间）、预后时间（胃肠通气恢复时间、开始下床时间和住院时间）以及不良反应发生情况。

结果

最终有64例产妇（观察组 32例、对照组32例）进入比较研究。与对照组相比，观察组产妇感觉恢复时间和运动恢复时间显著延长，胃肠通气恢复时间显著缩短，恶心呕吐和腹胀的发生率显著降低（

＜0.05）；两组其余指标比较，差异均无统计学意义（

＞0.05）。

结论

腰硬联合麻醉下罗哌卡因联合右美托咪定可提供与联合阿片类药物舒芬太尼相当的镇痛效果，并可缩短产妇胃肠通气恢复时间，降低恶心呕吐和腹胀的发生率，同时不增加低血压和尿潴留风险。

Abstract

OBJECTIVE

To investigate the effect of ropivacaine combined with dexmedetomidine on postoperative analgesia in women undergoing cesarean section， and to explore the feasibility of the opioid-free analgesia mode after cesarean section under spinal-epidural anesthesia.

METHODS

Totally 80 women undergoing cesarean section were randomly divided into observation group （ropivacaine combined with dexmedetomidine for analgesia） and control group （ropivacaine combined with opioid drug sufentanil for analgesia）， with 40 cases in each group. The exercise and rest score in visual analogue scale （VAS） within 48 hours after operation， the use of analgesia pump （the time of first analgesia pump pressing， the times of analgesia pump pressing within 24 hours and 48 hours after operation）， the time of block （the onset time of spinal anesthesia sensory block， the time to the highest level of spinal anesthesia sensory block， the time of sensory recovery and the time of movement recovery）， the time of prognosis （the time of gastrointestinal ventilation recovery， the time of getting out of bed and the hospitalization time）， and the incidence of adverse events were compared in 2 groups.

RESULTS

Finally， 64 parturients （32 in the observation group and 32 in the control group） were involved in the analysis. Compared with the control group， the recovery time of sensation and movement were significantly prolonged， the ventilation time was significantly shortened， and the incidence of nausea， vomiting and abdominal distension was significantly decreased in the observation group （

＜0.05） . There was no significant difference in the other indexes between the two groups （

＞0.05）.

CONCLUSIONS

Ropivacaine combined with dexmedetomidine under spinal-epidural anesthesia could provide similar analgesic effect as combined with opioids drug sufentanil， shorten the time of gastrointestinal ventilation recovery， and reduce the incidence of nausea， vomiting and abdominal distension， with no increased risk of low blood pressure or urinary retention.

关键词

Keywords

references

WEN X J ， HUANG B W ， LIANG X . Effect of ropivacaine and sufentanil in epidural labor analgesia [J ] . Am J Transl Res ， 2021 ， 13 （ 6 ）： 7001 - 7007 .

ZHI M J ， DIAO Y F ， LIU S Y ， et al . Sufentanil versus fentanyl for pain relief in labor involving combined spinal- epidural analgesia：a systematic review and meta-analysis of randomized controlled trials [J ] . Eur J Clin Pharmacol ， 2020 ， 76 （ 4 ）： 501 - 506 .

MIAO F F ， FENG K P ， FENG X X ， et al . The analgesic effect of different concentrations of epidural ropivacaine alone or combined with sufentanil in patients after cesa- rean section [J ] . Front Pharmacol ， 2021 ， 12 ： 631897 .

黄伟伟，张加强，刘莉影，等 . 不同剂量罗哌卡因腰-硬联合麻醉对剖宫产产妇术后VAS评分和血流动力学水平的影响 [J ] . 中国妇幼保健， 2022 ， 37 （ 17 ）： 3279 - 3282 .

YANG Y C ， SONG C J ， SONG C W ， et al . Addition of dexmedetomidine to epidural morphine to improve anesthesia and analgesia for cesarean section [J ] . Exp Ther Med ， 2020 ， 19 （ 3 ）： 1747 - 1754 .

BI Y H ， WU J M ， ZHANG Y Z ， 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 .

TANG Y W ， STANFORD S E R ， LUCAS D N ， et al . Comparison of the ED 50 of intrathecal hyperbaric ropivacaine co-administered with or without intrathecal dexmedetomidine for cesarean section：a prospective，double-blinded，randomized dose-response trial using up-down sequential allocation method [J ] . J Clin Anesth ， 2020 ， 62 ： 109725 .

KLIMEK M ， ROSSAINT R ， VAN DE VELDE M ， et al . Combined spinal-epidural vs. spinal anaesthesia for caesarean section：meta-analysis and trial-sequential analysis [J ] . Anaesthesia ， 2018 ， 73 （ 7 ）： 875 - 888 .

王永林 . 椎管内麻醉不同给药方法对剖宫产术中产妇优良率、不良反应分析 [J ] . 中外女性健康研究， 2022 （ 3 ）： 63 - 64，108 .

赵红彦，朱美玲，韦华，等 . 剖宫产术后6小时内下床活动对术后恢复的意义 [J/OL ] . 实用临床护理学电子杂志， 2019 ， 4 （ 29 ）： 155 - 156 [ 2022-04-05 ] . https：//xueshu.baidu.com/usercenter/paper/show?paperid=124g0eq0y57f0gp0by0b0c80b2063846&site=xueshu_se https://xueshu.baidu.com/usercenter/paper/show?paperid=124g0eq0y57f0gp0by0b0c80b2063846&site=xueshu_se .

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