老年患者下肢关节置换手术后舒芬太尼联合地佐辛静脉镇痛的疗效
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摘要
目的分析老年患者下肢关节置换手术后舒芬太尼联合地佐辛静脉镇痛的疗效。方法 2013年12月至2017年6月,于本院收治的择期行髋关节置换术的老年患者中选取50例,以随机数字表法为依据,分为两组,两组术后均行PCIA(自控静脉镇痛),对照组单独应用舒芬太尼,观察组联合舒芬太尼与地佐辛,对比术后不同时期两组VAS(视觉模拟疼痛)评分、Ramsay镇静评分、不良反应发生情况。结果与对照组对比,观察组患者术后3 h、6 h、12 h、24 h时的VAS评分更低,差异有统计学意义(P<0.05);与对照组对比,观察组患者术后3 h、6 h、12 h、24 h时的Ramsay评分更高,差异有统计学意义(P<0.05);观察组呼吸抑制、嗜睡、恶心、呕吐患者分别有0例、1例、0例、1例,不良反应发生率为8%,低于对照组的48%,差异有统计学意义(P<0.05)。结论老年患者下肢关节置换手术后舒芬太尼联合地佐辛静脉镇痛的疗效显著,安全性高,存在良好应用价值。
Objective To analyze the efficacy of sufentanil combined with dezocine intravenous analgesia in elderly patients after lower limb arthroplasty. Methods From December 2013 to June 2017, 50 elderly patients with hip arthroplasty were selected and divided into two groups based on random digital table method. The two groups were treated with PCIA(self controlled intravenous analgesia) after operation. The control group was treated with sufentanil alone. The observation group was combined with sufentanil and digocin. Two groups of VAS(visual analogue pain)scores, Ramsay sedation scores and adverse reactions were recorded at different times. Results Compared with the control group, the VAS scores of 3 h, 6 h, 12 h and 24 h in the observation group were lower, the difference was significant(P<0.05). Compared with the control group, the Ramsay scores of postoperative 3 h, 6 h, 12 h and 24 h were higher in the observation group, and the difference was significant(P<0.05); In the observation group, patients with respiratory depression, lethargy, nausea and vomiting were 0, 1, 0 and 1, respectively, the incidence of adverse reactions was 8%,lower than that of the control group 48%, the difference was significant(P<0.05). Conclusion Sufentanil combined with dezocine intravenous analgesia is effective and safe in elderly patients after lower limb arthroplasty.
Objective To analyze the efficacy of sufentanil combined with dezocine intravenous analgesia in elderly patients after lower limb arthroplasty. Methods From December 2013 to June 2017, 50 elderly patients with hip arthroplasty were selected and divided into two groups based on random digital table method. The two groups were treated with PCIA(self controlled intravenous analgesia) after operation. The control group was treated with sufentanil alone. The observation group was combined with sufentanil and digocin. Two groups of VAS(visual analogue pain)scores, Ramsay sedation scores and adverse reactions were recorded at different times. Results Compared with the control group, the VAS scores of 3 h, 6 h, 12 h and 24 h in the observation group were lower, the difference was significant(P<0.05). Compared with the control group, the Ramsay scores of postoperative 3 h, 6 h, 12 h and 24 h were higher in the observation group, and the difference was significant(P<0.05); In the observation group, patients with respiratory depression, lethargy, nausea and vomiting were 0, 1, 0 and 1, respectively, the incidence of adverse reactions was 8%,lower than that of the control group 48%, the difference was significant(P<0.05). Conclusion Sufentanil combined with dezocine intravenous analgesia is effective and safe in elderly patients after lower limb arthroplasty.
引文
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[5]段凤梅,孙旭颖,李玲,等.氢吗啡酮超前镇痛对老年患者术后认知功能及炎性细胞因子的影响[J].实用医学杂志,2016,32(13):2161-2163.
[6]鲁汉杰,张穗,李小亮,等.地佐辛联合舒芬太尼用于开腹手术后自控静脉镇痛的效果及护理[J].实用临床医药杂志,2014,18(12):45-47.
[7]陈芳,李洪,杜智勇,等.地佐辛联合舒芬太尼用于脊柱矫形术后镇痛的研究[J].局解手术学杂志,2016,25(10):724-728.
[8]夏中元,唐哨群,刘菊英.地佐辛联合舒芬太尼用于全麻术后患者静脉自控镇痛的临床效果及安全性:Meta分析[J].国际麻醉学与复苏杂志,2015,36(5):417-424.
[9]宋平,王飞.腹腔镜肝癌切除术后地佐辛联合舒芬太尼方案自控静脉镇痛对全身疼痛及炎症介质的影响[J].海南医学院学报,2017,23(13):1822-1825.
[11]段凤梅,孙旭颖,李玲.肋间神经阻滞复合氢吗啡酮静脉镇痛对老年患者术后认知功能及镇痛的影响[J].重庆医学,2017,46(1):54-56.
[12]胡柳,迟晓慧,张咸伟,等.曲马多与地佐辛联合舒芬太尼用于开胸术后静脉自控镇痛比较[J].医药导报,2016,35(s1):33-35.
[13]陈榕,夏中元,孟庆涛,等.地佐辛与舒芬太尼用于术后静脉自控镇痛临床效果的Meta分析[J].热带医学杂志,2014,14(6):805-810.
[14]王旭,高玉华,郭斌,等.罗哌卡因复合舒芬太尼或地佐辛连续股神经阻滞在全膝关节置换术后镇痛中的应用[J].临床麻醉学杂志,2016,32(3):258-261.
[15]武栋,程斌,高茂龙,等.小剂量纳美芬在老年髋部骨折患者术后静脉自控镇痛中的应用[J].首都医科大学学报,2016,37(2):241-244.
[2]张雁.不同剂量舒芬太尼联合右美托咪啶用于髋关节置换术后静脉镇痛的量效关系[J].中国医师杂志,2016,18(2):236-239.
[3]陈敬锋,许礼旭,陈磊,等.舒芬太尼联合地佐辛对乳腺癌患者术后静脉自控镇痛的临床研究[J].中国临床药理学杂志,2016,32(15):1387-1389.
[4]薛娜,王晖,王志华,等.地佐辛复合氟比洛芬酯对老年患者髋关节置换术后镇痛的效果[J].临床骨科杂志,2017,20(6):763-764.
[5]段凤梅,孙旭颖,李玲,等.氢吗啡酮超前镇痛对老年患者术后认知功能及炎性细胞因子的影响[J].实用医学杂志,2016,32(13):2161-2163.
[6]鲁汉杰,张穗,李小亮,等.地佐辛联合舒芬太尼用于开腹手术后自控静脉镇痛的效果及护理[J].实用临床医药杂志,2014,18(12):45-47.
[7]陈芳,李洪,杜智勇,等.地佐辛联合舒芬太尼用于脊柱矫形术后镇痛的研究[J].局解手术学杂志,2016,25(10):724-728.
[8]夏中元,唐哨群,刘菊英.地佐辛联合舒芬太尼用于全麻术后患者静脉自控镇痛的临床效果及安全性:Meta分析[J].国际麻醉学与复苏杂志,2015,36(5):417-424.
[9]宋平,王飞.腹腔镜肝癌切除术后地佐辛联合舒芬太尼方案自控静脉镇痛对全身疼痛及炎症介质的影响[J].海南医学院学报,2017,23(13):1822-1825.
[11]段凤梅,孙旭颖,李玲.肋间神经阻滞复合氢吗啡酮静脉镇痛对老年患者术后认知功能及镇痛的影响[J].重庆医学,2017,46(1):54-56.
[12]胡柳,迟晓慧,张咸伟,等.曲马多与地佐辛联合舒芬太尼用于开胸术后静脉自控镇痛比较[J].医药导报,2016,35(s1):33-35.
[13]陈榕,夏中元,孟庆涛,等.地佐辛与舒芬太尼用于术后静脉自控镇痛临床效果的Meta分析[J].热带医学杂志,2014,14(6):805-810.
[14]王旭,高玉华,郭斌,等.罗哌卡因复合舒芬太尼或地佐辛连续股神经阻滞在全膝关节置换术后镇痛中的应用[J].临床麻醉学杂志,2016,32(3):258-261.
[15]武栋,程斌,高茂龙,等.小剂量纳美芬在老年髋部骨折患者术后静脉自控镇痛中的应用[J].首都医科大学学报,2016,37(2):241-244.