| 李淑萍,陈宝军,胡淑娜,李玉虎,管进进.右美托咪定联合舒芬太尼用于脊柱手术患者术后镇痛的疗效评价[J].,2017,17(21):4147-4151 |
| 右美托咪定联合舒芬太尼用于脊柱手术患者术后镇痛的疗效评价 |
| The Curative Effect of Dexmedetomidine Combination with Sufentanil on Postoperative Analgesia in Patients with Spinal Surgery |
| 投稿时间：2016-10-23 修订日期：2016-11-20 |
| DOI：10.13241/j.cnki.pmb.2017.21.037 |
| 中文关键词: 右美托咪定 舒芬太尼 脊柱手术 镇痛 |
| 英文关键词: Dexmedetomidine Sufentanil Spinal surgery Analgesia |
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| 中文摘要: |
| 摘要 目的：探讨右美托咪定联合舒芬太尼对脊柱手术患者术后镇痛效果的影响。方法：选择2013年1月至2016年8月在我院行脊柱手术的患者70例，随机分为两组，每组35例。对照组患者术后静脉注入舒芬太尼3 μg/kg?h镇痛，观察组患者静脉注入右美托咪定1.5 μg/kg?h联合1.5 μg/kg?h舒芬太尼。分别记录患者术后6 h，12 h，24 h以及48 h的VAS评分、Ramsay评分、MAP、HR以及SpO2等生命指征；记录患者术后苏醒期10 min，20 min，30 min以及60 min的RSAS躁动评分；同时记录患者术后48 h不良反应发生的情况。结果：监护仪监护两组患者围手术期的相关生命指征，统计分析结果显示两组患者术后HR，MAP以及SpO2等指征没有明显的差异（P>0.05）；比较两组患者结束手术苏醒期的躁动情况，RSAS躁动评分显示实验组患者术后30 min之后较对照组相对安静，没有较明显的躁动行为（P<0.05）；实验组患者术后的VAS疼痛评分明显低于对照组（P<0.05）；比较两组患者的Ramsay评分发现实验组患者术后镇静程度显著优于对照组（P<0.05）；两组患者术后0-24 h使用镇痛泵的有效按压次数存在差异（P<0.05）；实验组患者术后48 h发生恶心呕吐和寒颤的不良反应发生率明显低于对照组（P<0.05）。结论：右美托咪定联合舒芬太尼用于脊柱手术术后镇痛可以显著改善患者镇静状态，降低患者术后发生不良反应的发生率，值得临床上进一步推广应用。 |
| 英文摘要: |
| ABSTRACT Objective: To evaluate the effect of combination of dexmedetomidine with sufentanil on postoperative analgesia in pa- tients with spinal surgery. Methods: 70 patients undergoing spinal surgery were enrolled from January 2013 to August 2016 in our hospi- tal, which randomly divided into two groups, control group (n=35) were all injected 3 μg/kg?h sufentanil intravenously, and study group (n=35) were adopted 1.5 μg/kg?h dexmedetomidine and 1.5 μg/kg?h sufentanil. The VAS and Ramsay score, MAP, HR and SpO2 after operation 6 h, 12 h, 24 h and 48 h was compared between two groups; the RSAS score after operation 10 min, 20 min, 30 min and 60 min in the recovery period was evaluated and compared between two groups; and the incidence of adverse reactions after operation 48 h be- tween two groups was detected. Results: Recording the life indication with monitor in the perioperative period, the difference of HR, MAP and SpO2 from two groups had no significance, respectively (P>0.05); Comparing the restlessness of the two groups in the recovery period after operation, the RSAS score showed that the patients of study group were silent and there was no obvious agitation behaviors compared with control group at 30 min after operation, and the difference between two groups was statistically significant (P<0.05); The VAS score of study group was lower than that of control group obviously (P<0.05); The Ramsay score showed the sedation level of study group was superior to control group with statistical significance (P<0.05); The difference of effective delivery times with analgesia pump was statistical significant with postoperative 0-24 h (P<0.05); The incidence of nausea and vomit and shiver of study group was lower than that of control group at 48 h after operation with statistical significance (P<0.05). Conclusion: Dexmedetomidine combined with sufentanil have good curative effect for postoperative analgesia of spinal surgery, which not only improve the sedation obviously, but also decrease the incidence of adverse reactions. |
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