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| Effect of Ketorolac Tromethamine Combined with Dexmedetomidine on Preemptive Analgesia in Patients Undergoing Cesarean Section |
| GAO Huai-xin, JIANG Liu-qin |
| Department of Anesthesiology,No.215 Hospital of Shaanxi Nuclear Industry,Xianyang Shaanxi 712000 |
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Abstract 【Objective】To investigate the effect of ketorolac tromethamine (KT) combined with dexmedetomidine (Dex) on preemptive analgesia in patients undergoing cesarean section. 【Methods】A total of 180 patients with cesarean section in our hospital were divided into two groups according to the order of admission. The 90 cases in the control group were given Dex plus equal volume normal saline for preemptive analgesia,and 90 cases in the observation group were given KT combined with Dex for preemptive analgesia. The incidence of postoperative shivering,postoperative pain,perioperative stress hormone levels,adverse reactions,and neonatal Apgar score were compared between the two groups. 【Results】The total incidence of postoperative shivering in the observation group was lower than that in the control group (P<0.05). The visual analogue scale (VAS) scores of the observation group at 6 h,12 h and 24 h after operation were lower than those of the control group at the same time points (P<0.05). The levels of renin (Rn),cortisol (Cor) and adrenocorticotropic hormone (ACTH) in the two groups at 2h after operation (T1) were higher than those before epidural puncture (T0) (P<0.05),and the levels of Rn,Cor and ACTH in the observation group at T1 were lower than those in the control group at T1 (P<0.05). After surgery,Rn,Cor,and ACTH levels of the two groups at T2 (8:00 am the next day post-operation) were higher than those at T0 (P<0.05). The levels of Rn,Cor and ACTH in the control group were higher than those at T1 (P<0.05),while the levels of Rn,Cor and ACTH in the observation group at T2 were lower than those in the control group at T2 (P<0.05). The incidence of nausea and vomiting in the observation group was lower than that in the control group (P<0.05). There was no significant difference in newborn Apgar score at 1 min and 5 min between the two groups (P>0.05). 【Conclusion】KT combined with Dex for preemptive analgesia in cesarean section can prevent postoperative shivering,enhance postoperative analgesic effect,inhibit perioperative stress reaction and reduce adverse reactions,while it does not affect the neonatal Apgar score.
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Received: 20 May 2022
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[1] 闫秋风. 剖宫产手术临床指征分析54例[J].中国药物与临床,2019,19(1):117-118.
[2] 马婕妤,宋琼. 氟比洛芬酯联合地佐辛超前镇痛对宫颈癌患者术后疼痛及免疫功能的影响[J].中国老年学,2018,38(13):3143-3146.
[3] 洪秀,赖忠盟. 超前镇痛的研究现状及在临床麻醉中的应用[J].福建医药杂志,2018,40(6):145-146.
[4] 时文波. 浅谈镇痛药的联合应用[J].中国医院用药评价与分析,2018,169(7):144-145.
[5] 王跃斌,孙广运,何常佑,等.右美托咪定不同给药方式麻醉在腹腔镜手术治疗子宫肌瘤中的麻醉效果研究[J].中国性科学,2018,27(3):34-36.
[6] 袁志国,刘新法,张杰,等. 酮咯酸氨丁三醇复合舒芬太尼用于剖宫产术后镇痛对凝血功能的影响[J].山东医药,2019,59(7):83-85.
[7] WITTE J D,DELOOF T,VEYLDER J D,et al. Tramadol in the treatment of postanesthetic shivering[J].Acta Anaesthesiol Scand,2010,41(4):506-510.
[8] CARLSSON A M. Assessment of chronic pain. I. Aspects of the reliability and validity of the visual analogue scale.[J].Pain,1983,16(1):87-101.
[9] 王大伟.小剂量舒芬太尼对预防剖宫产产妇术后寒战及牵拉痛发生的效果分析[J].中国社区医师,2020,36(15):30-31.
[10] 汤冰冰,李亚鹏,陈捷,等.椎管内辅助右美托咪定对预防蛛网膜下腔麻醉剖宫产术后寒战的Meta分析[J].医学研究杂志,2019,48(6):138-144.
[11] 傅志玲,张泽.曲马多联合酮咯酸氨丁三醇尼松用于妇科腹腔镜手术后患者静脉自控镇痛30例[J].医药导报,2019,38(2):213-217.
[12] 袁兵. 椎管内盐酸氢吗啡酮单次给药超前镇痛对剖宫产产妇镇痛效果、炎性因子及应激反应的影响[J].中国妇幼保健,2018,33(10):204-207.
[13] 马波,刘志恒,王显春.右美托咪定镇痛的临床应用进展[J].临床麻醉学杂志,2018,34(11):1136-1139.
[14] 石泉,李敏,唐志清,等. 酮咯酸氨丁三醇复合右美托咪定对瑞芬太尼致妇科腹腔镜患者术后痛觉过敏的影响[J].福建医科大学学报,2018,52(6):421-424. |
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. [J]. JOURNAL OF CLINICAL RESEARCH, 2023, 40(6): 955-958. |
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2023, Vol. 40 
