右美托咪定对膝关节置换术患者临床麻醉疗效以及短期睡眠状况的影响研究
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摘要
目的:研究右美托咪定对膝关节置换术患者临床麻醉疗效以及短期睡眠状况的影响,为临床治疗提供科学依据。方法:选取2016年2月至2017年2月内蒙古赤峰市第二医院麻醉科收治的准备实施膝关节置换术的患者172例,随机分为观察组(n=85)和对照组(n=87)。观察组使用右美托咪定联合坐骨神经及股神经阻滞麻醉进行治疗,对照组使用坐骨神经及股神经阻滞麻醉进行治疗。比较2组疗效及血流动力学指标变化。结果:1)手术开始30 min内2组患者MAP均有明显变化,且观察组直至手术完成,2组HR与麻醉前比较,差异有统计学意义(P <0. 05)。患者术后12 h测评疼痛与心态指数观察组优势明显(P <0. 05)。2) 2组患者临床疗效比较,观察组明显优于骨股组(P <0. 05)。3) 2组患者麻醉疗效比较,观察组明显优于骨股组(P <0. 05)。4)比较2组患者短期睡眠状况发现观察组明显优于对照组(P <0. 05)。结论:右美托咪定联合坐骨神经及股神经阻滞麻醉对膝关节置换术的临床效果明显,控制患者术间血液流动,减轻置换术对患者术后带来的负面影响。
Objective: To study dexmetomidine on clinical anaesthesia and short-term sleep status in patients with knee joint replacement. Methods: From February 2016 to February 2017,172 patients who were ready for knee joint replacement were selected retrospectively in Anesthesiology Department of The Second Hospital of Chifeng. According to the anesthesis-related drugs during the surgery,they were randomly divided into dexmetomidine combined with sciatic nerve and femoral nerve block anesthesia group( control group,85 cases) and sciatic nerve and femoral nerve block anesthesia( obervation group,87 cases). The changes of curative effect and hemodynamic indexes were studied in two groups. Results: 1) there were significant changes in MAP indexes in both groups within 30 minutes from the beginning of surgery,and the changes were obvious till the end of the surgery in dexmetomidine group. There was a significant difference in HR when compared with the pre-anesthesia data. There was significant difference in pain and mental state index between the two groups after the surgery for 12 hours( P < 0. 05). 2) when compared the clinical curative effect of the two groups,dexmetomidine group was significantly better than that of the femoral group( P < 0. 05). 3) when compared the anesthetic effect of the two groups,dexmetomidine group was significantly better than that of the right group( P < 0. 05).4) when compared the short-term sleep status of the two groups,dexmetomidine group was significantly better than the femoral group( P < 0. 05). Conclusion: The clinical effect of dexmetomidine combined with sciatic nerve and femoral nerve block anesthesia of knee joint replacement is obvious. It can control the interoperative blood flow and reduce the negative effect of replacement for the patients after surgery.
Objective: To study dexmetomidine on clinical anaesthesia and short-term sleep status in patients with knee joint replacement. Methods: From February 2016 to February 2017,172 patients who were ready for knee joint replacement were selected retrospectively in Anesthesiology Department of The Second Hospital of Chifeng. According to the anesthesis-related drugs during the surgery,they were randomly divided into dexmetomidine combined with sciatic nerve and femoral nerve block anesthesia group( control group,85 cases) and sciatic nerve and femoral nerve block anesthesia( obervation group,87 cases). The changes of curative effect and hemodynamic indexes were studied in two groups. Results: 1) there were significant changes in MAP indexes in both groups within 30 minutes from the beginning of surgery,and the changes were obvious till the end of the surgery in dexmetomidine group. There was a significant difference in HR when compared with the pre-anesthesia data. There was significant difference in pain and mental state index between the two groups after the surgery for 12 hours( P < 0. 05). 2) when compared the clinical curative effect of the two groups,dexmetomidine group was significantly better than that of the femoral group( P < 0. 05). 3) when compared the anesthetic effect of the two groups,dexmetomidine group was significantly better than that of the right group( P < 0. 05).4) when compared the short-term sleep status of the two groups,dexmetomidine group was significantly better than the femoral group( P < 0. 05). Conclusion: The clinical effect of dexmetomidine combined with sciatic nerve and femoral nerve block anesthesia of knee joint replacement is obvious. It can control the interoperative blood flow and reduce the negative effect of replacement for the patients after surgery.
引文
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[7]杨云朝,吴昱,陈鹤翔,等.右美托咪定辅助腰丛-坐骨神经联合阻滞在老龄患者下肢手术中的应用[J].医学综述,2015,21(1):144-147.
[8]徐海燕,刘卫华,刘琴湘,等.右美托咪定在老年人坐骨神经联合股神经阻滞后的临床观察[J].中国现代药物应用,2017,11(7):36-38.
[9]李娜,张晓威,刘晓宁.地佐辛联合右美托咪定对老年患者腰丛-坐骨神经阻滞麻醉效果的影响[J].吉林医学,2016,37(8):1939-1941.
[10]罗戎明,杨凯杰,郑晋伟,等.右美托咪定辅助腰丛联合坐骨神经阻滞在老年患者膝关节镜手术中的应用[J].中国现代医生,2016,54(28):117-120.
[11]陈琼仪.右美托咪定对老年人坐骨神经联合股神经阻滞镇痛效果影响的研究[J].中外医学研究,2016,14(21):22-24.
[12]毛琛璐,姜慧丽,崔苏扬.右美托咪定镇静在神经阻滞下肢手术患者的应用[J].江苏医药,2014,40(2):204-206.
[2]王美容,李志鹏,蒋群锰,等.右美托咪定配伍罗哌卡因单次坐骨神经阻滞对TKA术后股神经旁置管镇痛效果的影响[J].实用医学杂志,2017,33(7):1145-1148.
[3]史晓燕,崔永康,田兵.右美托咪定辅助腰丛-坐骨神经阻滞应用于膝关节表面置换术的临床效果[J].中国医师进修杂志,2012,35(z2):54-56.
[4]杨鸿刚,李凤琴.连续股神经阻滞联合右美托咪定对全膝关节置换术患者术后镇痛及血流动力学的影响[J].中国伤残医学,2017,25(14):61-62.
[5]薛利军,李继周,高彦东,等.右美托咪定对坐骨神经联合股神经阻滞麻醉膝关节置换术患者的镇静效果[J].中国医药,2016,11(6):874-876.
[6]辛学东.神经阻滞麻醉辅用右美托咪啶在膝关节置换术中的应用研究[J].内蒙古医科大学学报,2016,38(5):460-462.
[7]杨云朝,吴昱,陈鹤翔,等.右美托咪定辅助腰丛-坐骨神经联合阻滞在老龄患者下肢手术中的应用[J].医学综述,2015,21(1):144-147.
[8]徐海燕,刘卫华,刘琴湘,等.右美托咪定在老年人坐骨神经联合股神经阻滞后的临床观察[J].中国现代药物应用,2017,11(7):36-38.
[9]李娜,张晓威,刘晓宁.地佐辛联合右美托咪定对老年患者腰丛-坐骨神经阻滞麻醉效果的影响[J].吉林医学,2016,37(8):1939-1941.
[10]罗戎明,杨凯杰,郑晋伟,等.右美托咪定辅助腰丛联合坐骨神经阻滞在老年患者膝关节镜手术中的应用[J].中国现代医生,2016,54(28):117-120.
[11]陈琼仪.右美托咪定对老年人坐骨神经联合股神经阻滞镇痛效果影响的研究[J].中外医学研究,2016,14(21):22-24.
[12]毛琛璐,姜慧丽,崔苏扬.右美托咪定镇静在神经阻滞下肢手术患者的应用[J].江苏医药,2014,40(2):204-206.