مقایسه تأثیر افزودن پتدین به بوپی‌واکائین 5/0% و روپی‌واکائین 5/0% بر روی شدت بروز درد در زنان تحت عمل جراحی سزارین الکتیو با بی‌حسی نخاعی: یک مطالعه کارآزمایی بالینی تصادفی شده دوسویه‌کور

نوع مقاله : اصیل پژوهشی

نویسندگان

1 دانشیار گروه بیهوشی، مرکز تحقیقات بیهوشی و کنترل درد، دانشکده پزشکی، دانشگاه علوم پزشکی جهرم، جهرم، ایران.

2 استادیار گروه بیهوشی، مرکز تحقیقات بیهوشی و کنترل درد، دانشکده پزشکی، دانشگاه علوم پزشکی جهرم، جهرم، ایران.

3 دانشجوی پزشکی، کمیته تحقیقات دانشجویی، دانشکده پزشکی، دانشگاه علوم پزشکی جهرم، جهرم، ایران.

4 استادیار گروه زنان و نازایی، دانشکده پزشکی، دانشگاه علوم پزشکی جهرم، جهرم، ایران.

5 مربی گروه بیهوشی، مرکز تحقیقات مؤلفه‌های اجتماعی نظام سلامت، دانشکده پزشکی، دانشگاه علوم پزشکی جهرم، جهرم، ایران.

چکیده

مقدمه: اداره صحیح زایمان و روش بیهوشی مناسب جهت ایجاد بی‌دردی و حفظ سلامت مادر و جنین طی عمل سزارین، مسأ‍‍‍‌‌‌له‌ای بسیار مهم و حیاتی است. بنابراین مطالعه حاضر با هدف مقایسه تأثیر افزودن پتدین به بوپی‌واکائین 5/0% و روپی­واکائین 5/0% بر روی شدت بروز درد در زنان مراجعه‌کننده به بیمارستان مطهری تحت عمل جراحی سزارین الکتیو با بی‌حسی نخاعی انجام شد.
روش‌کار: این مطالعه کارآزمایی بالینی تصادفی شده دوسویه‌کور در سال 1400 بر روی 60 نفر از بیماران تحت عمل جراحی سزارین الکتیو مراجعه‌کننده به بیمارستان مطهری شهرستان جهرم انجام گرفت. بیماران به‌طور تصادفی و با استفاده از جدول اعداد تصادفی به دو گروه بوپی­واکائین- پتدین و روپی­واکائین- پتدین تقسیم شدند. میزان درد بیماران در هنگام ورود به ریکاوری، خروج از ریکاوری، 2، 6، 12 و 24 ساعت بعد از عمل مورد ارزیابی قرار گرفت. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS (نسخه 21) و آزمون‌های آماری تی‌تست، من‌ویتنی و کای اسکوئر انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته‌ها: بین گروه‌های پتدین+روپی­واکائین و پتدین+بوپی­واکائین از لحاظ درد در زمان‌های مختلف (05/0<p)، شدت درد پس از سزارین در زمان‌های ریکاوری و بعد از عمل (05/0<p) و از نظر مصرف مخدر در 12 ساعت بعد از عمل، تفاوت معنی‌داری وجود نداشت (05/0<p).
نتیجه‌گیری: بین گروه‌های پتدین+روپی­واکائین و پتدین+بوپی­واکائین از لحاظ شدت درد تفاوت معنی‌داری وجود نداشت. متخصص بیهوشی می‌تواند با توجه به شرایط بیمار هر یک از دو داروی روپی‌واکائین و بوپی‌واکائین را در بی‌حسی نخاعی مورد استفاده قرار دهد.

کلیدواژه‌ها

عنوان مقاله [English]

The effect of adding pethidine to bupivacaine 0.5% and ropivacaine 0.5% on pain intensity in women undergoing elective cesarean section with spinal anesthesia: A double-blind randomized clinical trial study

نویسندگان [English]

  • Hasan Zabetian 1
  • Mohammad Rahmanian 2
  • Mohammad Hasan Damshenas 2
  • Ahmad Rastgarian 2
  • Mahsa Nabipour 3
  • Naser Hatami 3
  • Farideh Mogharab 4
  • Navid Kalani 5
1 Associate Professor, Department of Anesthesiology, Anesthesiology and Pain Management Research Center, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
2 Assistant Professor, Department of Anesthesiology, Anesthesiology and Pain Management Research Center, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
3 General Physician, Student Research Committee, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
4 Assistant Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
5 Instructor, Department of Anesthesiology, Research Center for Social Determinants of Health, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
چکیده [English]

Introduction: Proper management of labor and proper anesthesia is very important in order to create pain relief and maintain the health of mother and fetus during cesarean section. Therefore, this study was performed aimed to compare the effect of adding pethidine to 0.5% bupivacaine and 0.5% bupivacaine on pain intensity in women undergoing elective cesarean section with spinal anesthesia referred to Motahhari Hospital.
Methods: This double-blind randomized clinical trial study was performed in 2021 on 60 patients undergoing elective cesarean section referred to Motahhari Hospital in Jahrom. Using the random number table, the patients were randomly divided into two groups: bupivacaine-pethidine and ropivacaine-pethidine. Patients' pain was assessed during entry into recovery, exit from recovery, 2, 6, 12 and 24 hours after the surgery. Data were analyzed using SPSS software (version 21) and T-test, Mann-Whitney and Chi-square test. P<0.05 was considered statistically significant.
Results: There was no significant difference between pethidine + ropivacaine and pethidine + bupivacaine groups in terms of pain at different times (P> 0.05), pain intensity after cesarean section during recovery and postoperative periods (P >0.05), and opiate use in 12 hours after the surgery (P >0.05).
Conclusion: There was no significant difference between the groups of pethidine + ropivacaine and pethidine + bupivacaine in terms of pain intensity. The anesthesiologist can use either ropivacaine or bupivacaine in spinal anesthesia, depending on the patient's condition.

کلیدواژه‌ها [English]

  • Bupivacaine
  • Cesarean section
  • Pain
  • Pethidine
  • Ropivacaine

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مجله زنان، مامایی و نازایی ایران
دوره 25، شماره 2
اردیبهشت 1401
صفحه 1-12

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