| 张 鹏,叶 霞,杨巧艳,张雅楠,李 娅.不同剂量盐酸羟考酮复合右美托咪定对开腹手术患者镇痛效应及血流动力学的影响[J].,2018,(15):2898-2901 |
| 不同剂量盐酸羟考酮复合右美托咪定对开腹手术患者镇痛效应及血流动力学的影响 |
| Influence of Analgesic Effect and Hemodynamics of Different Doses of Oxycodone Hydrochloride Combine Dexmedetomidine in Patients with Abdominal Surgery |
| 投稿时间：2017-10-13 修订日期：2017-11-10 |
| DOI：10.13241/j.cnki.pmb.2018.15.020 |
| 中文关键词: 不同剂量 盐酸羟考酮 右美托咪定 开腹手术 镇痛效应 血流动力学 |
| 英文关键词: Different doses Oxycodone hydrochloride Dexmedetomidine Abdominal surgery Analgesic effect Hemodynamics |
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| 中文摘要: |
| 摘要 目的：探讨不同剂量盐酸羟考酮复合右美托咪定对开腹手术患者镇痛效应及血流动力学的影响。方法：选择从2015年3月到2017年3月期间在我院接受开腹手术治疗的患者100例进行研究。根据随机数字表法对患者进行分组，A组（应用1.0 mg/kg的盐酸羟考酮及2.5 μg/kg的右美托咪定麻醉）、B组（应用0.75 mg/kg的盐酸羟考酮及2.5 μg/kg的右美托咪定麻醉）、C组（应用0.5 mg/kg的盐酸羟考酮及2.5 μg/kg的右美托咪定麻醉）和D组（应用1.0 mg/kg的盐酸羟考酮麻醉），每组各25例。对比各组镇痛效应满意度以及麻醉诱导前（T0）、插管即刻（T1）、插管后5 min（T2）时的血流动力学指标，并统计各组不良反应情况。结果：A、B、C三组的镇痛效应满意度均分别明显高于D组，差异均有统计学意义（均P＜0.05），A、B、C三组的镇痛效应满意度对比差异无统计学意义（P＞0.05）。A、B组T1时的收缩压（SBP）、舒张压（DBP）、平均动脉压（MAP）及心率（HR）水平均分别高于C、D组，差异有统计学意义（P＜0.05）；T0和T2时，各组的SBP、DBP、MAP及HR水平相比差异均无统计学意义（均P＞0.05）。各组T1时SBP、DBP、MAP及HR水平与T0时相比明显上升，而T2时又明显下降，差异均有统计学意义（P＜0.05）。B组不良反应总发生率为12.00%，明显低于A组的36.00%、C组的44.00%及D组的40.00%，差异均有统计学意义（均P＜0.05）。结论：不同剂量的盐酸羟考酮与右美托咪定复合麻醉对开腹手术患者的镇痛效应较好，并对患者的血流动力学水平均造成一定影响，但随着时间的延长而逐渐减弱，2.5 μg/kg的右美托咪定以及0.75 mg/kg的盐酸羟考酮复合麻醉的安全性较高，值得在临床上推广应用。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the influence of analgesic effect and hemodynamics of different doses of oxycodone hy- drochloride combine dexmedetomidine in patients with abdominal surgery. Methods: 100 patients who underwent abdominal surgery in our hospital from March 2015 to March 2017 were selected in the study. According to the random number table method, the patients were divided into group A (application of 1.0 mg/kg oxycodone and 2.5 μg/kg dexmedetomidine), group B (application of 0.75 mg/kg oxy- codone and 2.5 μg/kg dexmedetomidine), group C (application of 0.5 mg/kg oxycodone and 2.5 μg/kg dexmedetomidine), and group D (application of 1.0 mg/kg oxycodone), each group contained 25 cases. The satisfaction degree of analgesia effect in each group and hemodynamics indexes before anesthesia induction (T0), immediate intubation (T1), and 5min after intubation (T2) were compared, and the adverse reactions of each group were statistically analyzed. Results: The satisfaction degree of analgesia effect in group A, B and C were significantly higher than those in group D, and the differences were statistically significant (all P<0.05), there was no significant dif- ference in the satisfaction degree of analgesia effect between the three groups of A, B and C (P>0.05). The systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and heart rate (HR) levels in group A and B at T1 were higher than those in group C and D respectively, the differences were statistically significant (P<0.05). There was no statistically significant difference be- tween SBP, DBP, MAP and HR at T0 and T2 in each groups (P>0.05). The levels of SBP, DBP, MAP and HR at T1 increased signifi- cantly compared with those at T0, but decreased significantly at T2, the differences were statistically significant (P<0.05). The total inci- dence of adverse reactions in group B was 12.00%, which was significantly lower than 36.00% in group A, 44.00% in group C and 40.00% in group D, and the differences were statistically significant (all P<0.05). Conclusion: Different doses of oxycodone hydrochlo- ride combine dexmedetomidine have better anesthesia on the analgesic effect of abdominal surgery patients, it has some influence on the hemodynamic level of the patients, but as time goes on, it gradually decreases. The treatment with 2.5 μg/kg dexmedetomidine and 0.75 mg/kg oxycodone hydrochloride compound anesthesia of the higher safety, which is worthy of clinical application. |
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