老年患者腰椎术后应用右美托咪定对舒芬太尼术后镇痛的影响
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摘要
目的观察老年患者腰椎术后应用右美托咪定对舒芬太尼术后镇痛的影响。方法选取2015年1月-2016年1月在该院老年腰椎手术患者90例,随机分为观察组和对照组,每组45例,观察组患者在术后应用(舒芬太尼+右美托咪定)镇痛,对照组患者在术后应用舒芬太尼镇痛,观察两组患者的镇痛效果和不良反应。结果 (1)观察组在术后多个时间点的视觉模拟评分(VAS)与Ramesay镇静评分均优于对照组,组间差异有统计学意义(P<0.05);(2)观察组在各个时间点的血压、心率及血氧变化均比对照组稳定(P<0.05);(3)观察组不良反应发生率为6.6%,对照组不良反应发生率为37.7%,组间差异有统计学意义(P<0.05)。结论舒芬太尼合用右美托咪定可有效治疗老年患者腰椎术后疼痛,不良反应发生率低。
Objective To observe the effect of Dexmedetomidine on the postoperative analgesic efficacy of Sufentanil in elderly patients after lumbar spine surgery. Methods Ninety elderly patients who underwent lumbar spine surgery between January 2015 and January 2016 in Xiangya Hospital were randomly divided into two groups: observation group(n = 45) and control group(n = 45). In terms of postoperative analgesia, the patients in the observation group received Sufentanil combined with Dexmedetomidine; only Sufentanil was utilized in the control group. The efficiency of analgesia and post-anesthesia complications in the two groups were observed. Results VAS score and Ramesay score in the observation group were dramatically lower than those in control group(P < 0.05). Blood pressure, heart rate and oxygen saturation of the patients in the observation group were more stable than those of the patients in the control group(P < 0.05). The incidences of complications were significantly lower in the observation group when compared to those in the control group(6.6% vs 37.7%, P < 0.05). Conclusions Combination of Sufentanil with Dexmedetomidine is synergistically better in treatment of postoperative pain for patients who undergo lumbar spine surgery with low incidences of adverse reactions in comparison with Sufentanil only.
Objective To observe the effect of Dexmedetomidine on the postoperative analgesic efficacy of Sufentanil in elderly patients after lumbar spine surgery. Methods Ninety elderly patients who underwent lumbar spine surgery between January 2015 and January 2016 in Xiangya Hospital were randomly divided into two groups: observation group(n = 45) and control group(n = 45). In terms of postoperative analgesia, the patients in the observation group received Sufentanil combined with Dexmedetomidine; only Sufentanil was utilized in the control group. The efficiency of analgesia and post-anesthesia complications in the two groups were observed. Results VAS score and Ramesay score in the observation group were dramatically lower than those in control group(P < 0.05). Blood pressure, heart rate and oxygen saturation of the patients in the observation group were more stable than those of the patients in the control group(P < 0.05). The incidences of complications were significantly lower in the observation group when compared to those in the control group(6.6% vs 37.7%, P < 0.05). Conclusions Combination of Sufentanil with Dexmedetomidine is synergistically better in treatment of postoperative pain for patients who undergo lumbar spine surgery with low incidences of adverse reactions in comparison with Sufentanil only.
引文
[1]陈正,邵东华,杭黎华.右美托咪啶对靶控输注丙泊酚镇静时量效关系的影响[J].中国现代医学杂志,2013,23(14):71-74.
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[12]徐亚丰,宋莺春,徐飞.右旋美托咪啶对老年腰椎手术中血流动力学及认知能力的影响[J].中国组织工程研究,2015,19(11):1788-1792.
[13]CAI Y,XU H,YAN J,et al.Molecular targets and mechanism of action of dexmedetomidine in treatmentof ischemia/reperfusion injury[J].Molecular Medicine Reports,2014,9(5):1542-1550.
[14]袁作芝,王华.右旋美托咪啶预防术后认知功能障碍的研究进展[J].中国老年学杂志,2014,34(22):6543-6545.
[15]苏靖心,董铁立.右旋美托咪啶临床应用[J].中华实用诊断与治疗杂志,2012,26(6):521-522.
[16]唐冰,范志君.右旋美托咪啶的临床应用进展[J].转化医学电子杂志,2014,1(5):161-164.
[17]李颖波,余开峰,冉然.右旋美托咪啶复合舒芬太尼及曲马多用于骨科术后自控静脉镇痛[J].郧阳医学院学报,2011,30(1):8-10.
[2]李明清.中西结合治疗腰椎间盘突出症术后并发症的疗效观察[J].中国医药指南,2013,11(16):300-301.
[3]钟远鸣,周劲衍,李智斐,等.超前镇痛及规律性按时给药对腰椎间盘突出症术后疼痛及功能影响的临床研究[J].中国矫形外科杂志,2014,22(4):369-372.
[4]余德华.老年术后认知功能障碍及右美托咪啶在其治疗中的作用[J].中国医药导报,2015,12(6):164-168.
[5]赵伟,李晓兰,何军霞,等.右美托咪定复合曲马多缓解治疗老年患者术后疼痛的效果观察[J].河北医药,2015,37(20):3115-3117.
[6]李欣,李猛.胸腰椎病变的放射诊断分析[J].按摩与康复医学,2015,6(17):116-117.
[7]孙兵,车晓明.视觉模拟评分法[J].中华神经外科杂志,2012,28(6):645-645.
[8]李梅,郭建桃,尤之斌.右美托咪啶在下肢手术患者经腰硬联合麻醉中的应用[J].中国乡村医药,2015,22(23):13-14.
[9]黎德洪,胡鑫森.舒芬太尼和芬太尼在腹腔镜手术麻醉中的应用对比[J].医药,2015(9):68-68.
[10]徐露,李元海.舒芬太尼的药理作用和临床应用研究进展[J].安徽医药,2011,15(3):375-377.
[11]姜世良.舒芬太尼复合氯胺酮、托烷司琼用于术后静脉镇痛的临床观察[J].中国当代医药,2014,21(5):51-53.
[12]徐亚丰,宋莺春,徐飞.右旋美托咪啶对老年腰椎手术中血流动力学及认知能力的影响[J].中国组织工程研究,2015,19(11):1788-1792.
[13]CAI Y,XU H,YAN J,et al.Molecular targets and mechanism of action of dexmedetomidine in treatmentof ischemia/reperfusion injury[J].Molecular Medicine Reports,2014,9(5):1542-1550.
[14]袁作芝,王华.右旋美托咪啶预防术后认知功能障碍的研究进展[J].中国老年学杂志,2014,34(22):6543-6545.
[15]苏靖心,董铁立.右旋美托咪啶临床应用[J].中华实用诊断与治疗杂志,2012,26(6):521-522.
[16]唐冰,范志君.右旋美托咪啶的临床应用进展[J].转化医学电子杂志,2014,1(5):161-164.
[17]李颖波,余开峰,冉然.右旋美托咪啶复合舒芬太尼及曲马多用于骨科术后自控静脉镇痛[J].郧阳医学院学报,2011,30(1):8-10.