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目的：观察静脉应用右美托咪定对二次剖宫产瘢痕子宫患者硬膜外麻醉的影响。方法硬膜外麻醉下行二次剖宫产术患者40例随机均分为两组：D组辅用右美托咪定1μg／kg ，10 min内静脉输注，其后以0．4μg?kg‐1?h‐1持续输注至术毕；N组以生理盐水替代右美托咪定作为对照。记录麻醉前（T0）、硬膜外注药完毕后10 min（T1）、30 min（T2）和术毕（T3）4个时点的MAP和 HR ，比较两组硬膜外阻滞起效时间、最高平面和达最高平面的时间，评估术中Ram say镇静评分和牵拉反应程度，记录胎儿娩出前使用雷米芬太尼的例数以及呼吸抑制和寒战反应发生情况。胎儿娩出后，抽取脐静脉血行血气分析，并记录新生儿1‐min和5‐min时的Apgar评分。结果两组患者各时点的MAP、HR和硬膜外麻醉效果比较差异无统计学意义（P＞0．05）。与 N组比较，D组镇静合作程度高（P＜0．05），术中牵拉反应轻（P＜0．05），使用雷米芬太尼的例数少（P＜0．05），患者呼吸抑制和寒战的发生率低（P＜0．05）。两组脐静脉血气分析和新生儿出生后1‐min和5‐min时的Apgar评分比较差异均无统计学意义（P＞0．05）。结论右美托咪定静脉用于二次剖宫产瘢痕子宫患者可增强硬膜外麻醉的效果，对新生儿无不良影响。“,”Objective To observe the effect of auxiliary use of dexmedetomidine in parturients undergoing secondary Caesarean section under epidural anesthesia .Methods Forty parturients undergoing secondary Caesarean section under epidural anesthesia were equally randomized into two groups .The patients in group D were infused dexmedetomidine 1μg/kg within 10 minutes ,which was followed by an intravenous infusion of dexmedetomidine 0 .4μg?kg‐1 ?h‐1 until the end of operation . The patients in group N were infused normal saline as the controls .The MAP and HR were recorded before anesthesia (T0 ) ,at 10 minutes (T1 ) and 30 minutes (T2 ) after the end of epidural administration ,and at the end of operation(T3) .The onset time ,maximum sensory plane ,the time to maximum sensory plane were recorded as well .The sedation scores and response to traction during surgery were evaluated .The number of patients using remifentanil before fetal birth and the incidence of respiratory depression and shivering were compared between two groups .The 1‐ and 5‐minute Apgar scores of neonates were recorded and the blood samples were drawn from umbilical vein for analysis .Results There were no significant differences in MAP and HR at each time point and the outcomes of epidural anesthesia between two groups(P>0 .05) .Compared with group N ,the patients in group D had better sedation and less responses to surgery traction (P<0 .05) ,less number of the patients using remifentanil before fetal birth ,lower incidence of respiratory depression and shivering (P0 .05 ) .Conclusion The auxiliary use of dexmedetomidine in the parturients undergoing secondary Caesarean section can enhance the effects of epidural anesthesia without adverse effects on neonates .