Clinical Effect Of Sufentanil,nalbuphine And Dexmedetomidine On Postoperative Analgesia After Cesarean Section

Objective:To observe the effect of hemodynamics of sufentanil,nabufine combined with dexmedetomidine for patient controlled intravenous analgesia after cesarean section through prospective clinical control trial.To analyze the effect of this analgesic method on this postoperative analgesia method after cesarean section.To explore the effect of this analgesic method on sleep quality,lactation and adverse reactions of parturients after cesarean section.Methods:From March to December 2019,200 primiparas who underwent cesarean section in our hospital were selected as the study objects,and they were divided into the control group and the observation group with the method of random number table.The patients of two groups were anesthetized by the same anesthesiologist,the combined spinal and epidural anesthesia was used in cesarean section,the patient controlled intravenous analgesia was used postoperative.In patient controlled intravenous analgesia after operation,the sufentanil 1μg/kg combined with nabufine 1 mg/kg was used in the control group,the sufentanil 1μg/kg,nabufine 1 mg/kg and dexmedetomidine 1 μg/kg were used in the observation group.The heart rate,mean arterial pressure and oxygen saturation were measured before operation,6h,12h,24h and 48h after operation.The times of compression of analgesia pump after operation were recorded.The analgesic and sedative effects of the patients were evaluated at 1H,3h,6h,9h,12h,24h and 36h after operation.The sleep quality and prolactin level were measured at 12h,24h and 48h after operation.The first lactation time and adverse reactions were recorded accurately.The SPSS 21.0 was used to analyze the observation indexes.Results:1.There was no significant difference in heart rate,mean arterial pressure and oxygen saturation of blood between the two groups before operation,6h,12h,24h and 48h after operation(P>0.05).2.The compression times of analgesia pump in the observation group were significantly less than that in the control group(P<0.05).There was no significant difference in VAS score of quiet state between the two groups at 1h,3h,6h,9h,12h,24h and 36h after operation(P>0.05).There was no significant difference in Ramsay Sedation scores between the two groups at 1h,3h,6h,9h,12h,24h and 36h after operation(P>0.05).3.The AIS score of observation group was significantly lower than that of control group at 12h and 24h after operation(P<0.05).However,there was no significant difference of AIS score between the two groups at 48h after operation(P>0.05).4.The first lactation time of the observation group was significantly shorter than that of the control group(P<0.05).The level of prolactin in the observation group was significantly higher than that in the control group at 12h and 24h after operation(P<0.05).But there was no significant difference in prolactin level between the two groups at 48h after operation(P>0.05).5.The total incidence of adverse reactions such as nausea and vomiting,respiratory inhibition and pruritus in the observation group was significantly lower than that in the control group(P<0.05).Conclusion:The sufentanil,nabufine combined with dexmedetomidine can further improve the effect of postoperative analgesia after cesarean section.It can improve the sleep quality and lactation of parturient after operation,and prevent the occurrence of anesthesia related adverse reactions.