| 邓 玲,周 扬,张冬青,汤思敏,屠伟峰.右美托咪定对脊柱手术患者术后镇痛效果的影响[J].,2017,17(33):6536-6539 |
| 右美托咪定对脊柱手术患者术后镇痛效果的影响 |
| Effects of Dexmedetomidine on the Patient-Controlled Intravenous Analgesia in Patients Undergoing Spine Operation |
| 投稿时间：2017-05-14 修订日期：2017-06-09 |
| DOI：10.13241/j.cnki.pmb.2017.33.031 |
| 中文关键词: 右美托咪定 地佐辛 术后镇痛 脊柱手术 |
| 英文关键词: Dexmedetomidine Dezocine Postoperative analgesia Spine operation |
| 基金项目:广东省科技计划项目（2014A020212410） |
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| 中文摘要: |
| 摘要 目的：观察不同剂量的右美托咪定(Dexmedetomidine，DEX)对于脊柱手术患者术后自控镇痛(Patient-Controlled Analgesia，PCA)效果的影响。方法：将90例全身麻醉下行择期脊柱手术的患者，随机分为3组，每组30例。术后，给予各组患者静脉自控镇痛，各组镇痛泵药物配方分别为：A组：氟比洛芬酯(Flurbiprofen Axetil，FLA) 2.5 mg/kg+地佐辛(Dezocine，DEZ) 0.6 mg/kg+帕洛诺司琼(Palonosetron，PAL) 0.01 mg/kg；B组：DEX(4.0 μg/kg)+DEZ(0.6 mg/kg)+PAL(0.01 mg/kg)；C组：DEX(6.0 μg/kg)+DEZ(0.6 mg/kg)+PAL(0.01 mg/kg)。在术后2、6、12、24和48 h，分别观察和比较患者的视觉疼痛评分(Visual Analogue Scale， VAS)、Ramsay镇静评分、自控镇痛按压次数和不良反应的发生情况。结果：各组患者术后2、6、12、24和48 h的VAS评分比较差异无统计学意义(P>0.05)。与A组比，B组和C组自控镇痛总按压次数和恶心呕吐的发生率均显著降低(P<0.05)，而Ramsay镇静评分显著升高(P<0.01)。与B组比，C组患者在术后12 h和24 h的Ramsay镇静评分显著升高(P<0.05)。结论：在脊柱患者术后自控镇痛中，使用DEX(4.0 μg/kg)联用+DEZ+PAL的镇痛方案可产生较好的镇痛和镇静效果，术后恶心呕吐发生率也更低。 |
| 英文摘要: |
| ABSTRACT Objective: To observe the analgesic effects of different doses of dexmedetomidine (DEX) combined with dezocine (DEZ) on the patients undergoing spine operation. Methods: Ninety cases of patients undergoing spinal surgery were randomly divided into three groups. Patients of group A received flurbiprofen axetil (FLA) of 2.5 mg/kg,dezocine (DEZ) of 0.6 mg/kg plus palonosetron (PAL) of 0.01 mg/kg for postoperative analgesia. Patients of group B received dexmedetomidine (DEX) of 4.0 μg/kg , DEX of 0.6 mg/kg plus PAL of 0.01 mg/kg. Patients of group C received DEX of 6.0 μg/kg,DEZ of 0.6 mg/kg plus PAL of 0.01 mg/kg. The visual analogue scale (VAS) and Ramsay sedation scores were recorded at 2, 4 ,6, 12, 24 and 48 h after operation. The effective pressing times, total times of patient-controlled analgesia and incidence of adverse effects were also assessed. Results: There was no statistical difference in the VAS score among the three groups (P>0.05). Compared with group A, the total times of Patient-controlled analgesia and incidence of nausea and vomiting in the group B and group C were obviously lower(P<0.05), and Ramsay scores was significantly higher in the group B and group C(P<0.05). Compared with group B, the Ramsay scores were higher at 12 h and 24 h in the group B and group C(P<0.05). Conclusion: In the spine operation undergoing spine operation, DEX(4.0 μg/kg)+DEZ+PAL could achieve a better analgesic and sedative effects with low incidence of nausea and vomiting. |
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