| 张 羽,罗 红,毛祖旻,吕倩雯,王 洪.诱导前右美托咪定泵注联合髂筋膜阻滞对老年髋部手术患者镇痛效果及术后寒战的影响[J].,2023,(19):3699-3703 |
| 诱导前右美托咪定泵注联合髂筋膜阻滞对老年髋部手术患者镇痛效果及术后寒战的影响 |
| Effect of Dexmedetomidine Pumping Combined with Fascia Iliac Block on Analgesia and Postoperative Chills in Elderly Patients Undergoing Hip Surgery |
| 投稿时间：2023-03-03 修订日期：2023-03-24 |
| DOI：10.13241/j.cnki.pmb.2023.19.020 |
| 中文关键词: 右美托咪定 髂筋膜阻滞 髋部手术 |
| 英文关键词: Dexmedetomidine Fascia iliac block Hip surgery |
| 基金项目:江苏省自然科学基金项目（19-5012） |
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| 中文摘要: |
| 摘要 目的：探讨诱导前右美托咪定泵注联合髂筋膜阻滞对老年髋部手术患者镇痛效果及术后寒战的影响。方法：选取我院2019年10月到2023年2月收治的60例髋部手术患者作为研究对象，将其分为观察组与对照组，每组30例。观察组在诱导前15分钟内泵注完20 mL含0.5 μg/kg右美托咪定的溶液，对照组泵注20 mL的生理盐水。在泵注的同时对两组患者采取40 mL 0.33%罗哌卡因进行髂筋膜阻滞，待阻滞效果满意后进行全身麻醉诱导。对比两组患者术后2 h（T1）、术后6 h（T2）、术后12 h（T3）和术后24 h（T4）的VAS评分、Ramsay评分、舒适度评分；术后24 h内寒战发生情况和不良反应发生率。结果：观察组患者术后各个观测时间点的VAS评分低于对照组（P＜0.05）；观察组在T1、T2时间点的Ramsay评分高于对照组（P＜0.05）；观察组患者术后各个观测时间点的舒适度评分较对照组高（P＜0.05）；观察组术后24 h内寒战发生率、寒战持续时间以及单次追加曲马多次数明显低于对照组（P＜0.05）；两组患者心动过缓、低氧血症、低血压的发生率对比无明显差异（P＞0.05）。结论：诱导前右美托咪定泵注联合髂筋膜阻滞可降低髋部手术患者术后疼痛，缓解术后寒战，提高患者舒适度，而未产生明显不良反应。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effect of induced dexmedetomidine pumping combined with fascia iliac block on the analgesic effect and postoperative chills in elderly patients undergoing hip surgery. Methods: A total of 60 hip surgery patients admitted to our hospital from October 2019 to February 2023 were selected as research subjects, and they were divided into observation group and matched group, with 30 cases in each group. The observation group pumped 20 mL of solution containing 0.5 μg/kg dexmedetomidine within 15 minutes before induction, and the matched group pumped 20 ml of normal saline. At the same time of pumping, 40 mL of 0.33% ropivacaine was taken to the two groups for fascial iliac blockade, and general anesthesia induction was performed after the blocking effect was satisfactory. The VAS score, Ramsay score and comfort score of 2 h (T1), 6 h (T2), 12 h (T3) and 24 h (T4) after surgery were compared between the two groups. Occurrence of chills and incidence of adverse reactions within 24 hours after surgery. Results: The VAS scores of each observation time point in the observation group were significantly lower than those in the matched group (P<0.05), the Ramsay scores in the observation group at T1 and T2 time points were higher than those in the matched group(P<0.05), the comfort score of each observation time point in the observation group was higher than that in the matched group(P<0.05), the incidence of chills, the duration of chills and the number of single tramadol supplements in the observation group within 24 hours after surgery were lower than those in the matched group(P<0.05). There was no significant difference in the incidence of hypoxemia and hypotension (P>0.05). Conclusion: Pre-induction dexmedetomidine pumping combined with fascia iliac block can reduce postoperative pain, relieve postoperative chills, and improve patient comfort in hip surgery patients without obvious adverse effects. |
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