髋关节置换患者术后镇痛中右美托咪定应用浓度研究
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摘要
目的:研究髋关节置换患者术后镇痛的右美托咪定应用浓度。方法:选取髋关节置换手术的患者100例,采用随机数表随机分为观察组和对照组50例。其中对照组采用0.5μg/ml的右美托咪定联合0.1%的罗哌卡因进行治疗,观察组采用1.0μg/ml的右美托咪定联合0.1%的罗哌卡因进行治疗。两组患者均持续镇痛48h,观察并记录两组患者镇痛的有效情况,同时比较两组患者不良反应的发生情况。结果:两组患者相比,观察组镇痛效果较好,镇痛有效率高达94.0%远远高于对照组82.0%,差异均有统计学意义(P<0.05)。两组患者治疗前VAS评分基本一致,手术后观察组患者评分降至(2.2±0.3)分,明显低于对照组(4.7±0.4)分,差异有统计学意义(P<0.05)。两组患者相比,观察组患者发生恶心呕吐、皮肤瘙痒的人数明显降低,差异有统计学意义(P<0.05)。结论:1.0μg/ml的右美托咪定联合0.1%的罗哌卡因,应用于髋关节置换手术患者,具有更好的镇痛效果和较少的不良反应,适合在临床上进行推广使用。
Objective:To study the application concentration of dexmedetomidine in postoperative analgesia for patients with hip replacement. Methods:100 cases of hip replacement surgery were randomly divided into observation group and control group with random number table. The control group was treated with 0.5 μg/ml dexmedetomidine combined 0.1 % ropivacaine for treatment, and the observation group was treated with 1.0 μ g/ml dexmedetomidine combined 0.1 % ropivacaine for treatment. Both groups lasted for 48 h, observed and recorded the effective situation of pain relief in both groups, and compared the incidence of adverse reactions between the two groups.Results:The analgesic effect of the observation group was better than that of the control group( 94.0 %), which was significantly higher than that of the control group( 82.0 %)(P<0.05). The vas score of the two groups before treatment was basically consistent, the score of the postoperative observation group decreased to(2.2±0.3) points, significantly lower than the control group(4.7±0.4) points, the difference was statistically significant(P<0.05). Compared with the two groups, the number of patients with nausea and vomiting and skin itching in the observation group was significantly lower, the difference was statistically significant(P<0.05). Conclusion:The efficacy of cell capsule combined with Ora in the treatment of acute cerebral infarction is better than that of Ora alone, and the MMSE and ADL scores of combined therapy are significantly better than those of Ora alone.
Objective:To study the application concentration of dexmedetomidine in postoperative analgesia for patients with hip replacement. Methods:100 cases of hip replacement surgery were randomly divided into observation group and control group with random number table. The control group was treated with 0.5 μg/ml dexmedetomidine combined 0.1 % ropivacaine for treatment, and the observation group was treated with 1.0 μ g/ml dexmedetomidine combined 0.1 % ropivacaine for treatment. Both groups lasted for 48 h, observed and recorded the effective situation of pain relief in both groups, and compared the incidence of adverse reactions between the two groups.Results:The analgesic effect of the observation group was better than that of the control group( 94.0 %), which was significantly higher than that of the control group( 82.0 %)(P<0.05). The vas score of the two groups before treatment was basically consistent, the score of the postoperative observation group decreased to(2.2±0.3) points, significantly lower than the control group(4.7±0.4) points, the difference was statistically significant(P<0.05). Compared with the two groups, the number of patients with nausea and vomiting and skin itching in the observation group was significantly lower, the difference was statistically significant(P<0.05). Conclusion:The efficacy of cell capsule combined with Ora in the treatment of acute cerebral infarction is better than that of Ora alone, and the MMSE and ADL scores of combined therapy are significantly better than those of Ora alone.
引文
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[8] 刘双梅,仲宇,吴秀英. 右美托咪定复合罗哌卡因骶管阻滞应用于小儿先天性髋关节脱位手术的影响[J]. 中国实验诊断学,2017,21(6):1025-1027.
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[10] 周小平,邓威,程嘉,等. 右美托咪定预给药在妇科手术中对瑞芬太尼麻醉后痛觉过敏的影响[J]. 中华临床医师杂志,2016,10(24):3748-3751.
[11] 柳青,李伯恩,何先弟. 右美托咪定在急性呼吸窘迫综合征患者镇静治疗中的疗效观察[J]. 中华全科医学,2015,13(12):1926-1928,2006.
[12] 林欣,沈亚芳,谢莉. 右美托咪定镇痛对小鼠脾自然杀伤细胞活性及淋巴细胞增殖功能的影响[J]. 中华实用诊断与治疗杂志,2016,30(5):452-454.
[13] 杨艳琴. 右美托咪定对老年性全髋关节置换术患者小剂量布比卡因腰麻的影响[J]. 中华临床医师杂志,2015,9(13):2516-2520.
[14] 马丁雷,刘苏,张锦荣,等.右美托咪定在重型颅脑外伤患者手术麻醉中脑保护作用研究[J].陕西医学杂志,2017,46(1):30-32.
[15] YaDeau JT,Gordon MA,Goytizolo EA,et al.Buprenorphine,clonidine dexamethasone,and ropivacaine for interscalene nerve blockade:a prospective,randomized,blinded,ropivacaine dose-response study[J].Pain Med,2016,17(5):940-960.
[16] 朱兆平,郭艾芳.右美托咪定联合氟比洛芬酯用于肺癌根治术患者超前镇痛效果观察[J].陕西医学杂志,2018,47(1):108-110.
[17] Kathuria S,Gupta S,Dhawan I.Dexmedetomidine as an adju-vant to ropivacaine in supraclavicular brachial plexus block[J].Saudi J Anaesth,2015,9(2):148-154.
[18] 潘桂芳,侯瑞礁.右美托咪定滴鼻联合七氟醚吸入麻醉在小儿先天性上睑下垂手术中的镇痛效果及对应激反应的影响[J].陕西医学杂志,2018,47(4):420-422.
[2] 张在斌,杨进国,曾文强,等. 右美托咪定对老年髋关节置换患者术后应激反应和短期认知功能的影响[J]. 实用药物与临床,2017,20(1):34-38.
[3] 孙可,金梅,杨庆国. 罗哌卡因复合右美托咪定髂筋膜间隙阻滞对预防老年髋关节置换术苏醒期躁动的效果[J]. 实用医学杂志,2016,32(22):3769-3771.
[4] 杨帅,华丽,王雄,等. 右美托咪定与布托啡诺用于老年全髋关节置换术后自控镇痛效果的比较[J]. 四川医学,2017,38(1):36-39.
[5] 刘冲,王志学,董龙,等. 静脉辅助右美托咪定复合瑞芬太尼对腰丛-坐骨神经阻滞老年髋关节置换患者术中循环呼吸与镇静的影响[J]. 中国老年学杂志,2016,36(23):5928-5931.
[6] 李阳波,田学勇,王靖.针刺联合舒芬太尼用于老年髋关节置换术后镇痛疗效观察[J].陕西中医,2015,36(1):100-102.
[7] 朱富祖,白毅平,卓帅,等. 右美托咪定对老年患者髋关节置换围术期炎症反应和肾脏功能的影响[J]. 中国现代医学杂志,2017,27(10):98-102.
[8] 刘双梅,仲宇,吴秀英. 右美托咪定复合罗哌卡因骶管阻滞应用于小儿先天性髋关节脱位手术的影响[J]. 中国实验诊断学,2017,21(6):1025-1027.
[9] 宫尚珍,原桂华,高庆娟,等. 右美托咪定对上腹部手术患者术后芬太尼镇痛效果的影响[J]. 中华全科医学,2017,15(1):57-59.
[10] 周小平,邓威,程嘉,等. 右美托咪定预给药在妇科手术中对瑞芬太尼麻醉后痛觉过敏的影响[J]. 中华临床医师杂志,2016,10(24):3748-3751.
[11] 柳青,李伯恩,何先弟. 右美托咪定在急性呼吸窘迫综合征患者镇静治疗中的疗效观察[J]. 中华全科医学,2015,13(12):1926-1928,2006.
[12] 林欣,沈亚芳,谢莉. 右美托咪定镇痛对小鼠脾自然杀伤细胞活性及淋巴细胞增殖功能的影响[J]. 中华实用诊断与治疗杂志,2016,30(5):452-454.
[13] 杨艳琴. 右美托咪定对老年性全髋关节置换术患者小剂量布比卡因腰麻的影响[J]. 中华临床医师杂志,2015,9(13):2516-2520.
[14] 马丁雷,刘苏,张锦荣,等.右美托咪定在重型颅脑外伤患者手术麻醉中脑保护作用研究[J].陕西医学杂志,2017,46(1):30-32.
[15] YaDeau JT,Gordon MA,Goytizolo EA,et al.Buprenorphine,clonidine dexamethasone,and ropivacaine for interscalene nerve blockade:a prospective,randomized,blinded,ropivacaine dose-response study[J].Pain Med,2016,17(5):940-960.
[16] 朱兆平,郭艾芳.右美托咪定联合氟比洛芬酯用于肺癌根治术患者超前镇痛效果观察[J].陕西医学杂志,2018,47(1):108-110.
[17] Kathuria S,Gupta S,Dhawan I.Dexmedetomidine as an adju-vant to ropivacaine in supraclavicular brachial plexus block[J].Saudi J Anaesth,2015,9(2):148-154.
[18] 潘桂芳,侯瑞礁.右美托咪定滴鼻联合七氟醚吸入麻醉在小儿先天性上睑下垂手术中的镇痛效果及对应激反应的影响[J].陕西医学杂志,2018,47(4):420-422.