摘要
目的探讨不同剂量舒芬太尼联合右美托咪啶用于髋关节置换患者术后静脉镇痛的临床效能及安全性。方法60例髋关节置换术后静脉镇痛患者，按随机数字表法分为3组：A组（舒芬太尼0．5μg/kg）、B组（舒芬太尼0．75μg/kg）、C组（舒芬太尼1μg／kg），均联合右美托咪啶1．5μg/kg。记录各组T1（术后4h）、T2（术后8h）、T3（术后24h）、T4（术后48h）的平均动脉压（MAP）、HR、血氧饱和度（SpO2）、镇痛评分（NRS）、镇静评分（Ramsay），T0（术前）、T3、T4的髋关节评分（Hat-ris），记录患者术后48h内自控静脉镇痛泵（PCIA）按压总次数及地佐辛用量及各组的不良反应发生情况。结果MAP、HR、SpO2：三组组间及组内各时点比较差异无统计学意义（P〉0．05）。NRS评分：B、C组低于A组（P〈0．01）；B、C组间比较各时点差异无统计学意义（P〉0．05）。Ramsay评分：B、C组T1、T2时评分高于A组（P〈0．01）；B、C组组问比较各时点差异无统计学意义（P〉0．05）。Harris评分：B、C组T3、T4时评分高于A组（P〈0．01）；B、C组组问比较各时点差异无统计学意义（P〉0．05）。不良反应：A、B组不良反应发生率低于C组（P〈0．01）；A、B组组间比较差异无统计学意义（P〉0．05）；与A组比较，B、C组的PCIA按压总次数及地佐辛用量均明显减少（P〈0．01）。结论0．75μg/kg舒芬太尼联合1．5μg/kg右美托咪啶用于髋关节置换术后静脉镇痛效果确切、镇静满意、不良反应少，为PCIA理想的药物配方。
Objective To investigate the dose-effect relationship of sufentanil combined with dexmedetomidine which used in clinical effectiveness and safety of intravenous analgesia after hip arthroplasty. Methods Sixty patients （after hip arthroplasty ） were randomly divided into three groups： group A （sufentanil 0.5 μg/kg）, group B （sufentanil 0.75 μg/kg） , and group C （sufentanil 1 μg/kg）. Each group was combined with dexmedetomidine 1.5 μg/kg in patient controlled analgesia （PCA） pump. Mean arterial pressure （MAP）, heart rate （HR）, SpO2, numerical rating scale （NRS） scores, and Ramsay sedation scores were recorded at Tl （4 h after operation） , T2 （8 h after operation） , T3 （24 h after operation） , and T4（48 h after operation）. Harris hip scores were recorded at T0（preoperative） , T3, and T4. The total number of pushing patient controlled intravenous analgesia （PCIA）, dezocine dosage, and the occurrence of adverse events in each group situation were recorded. Results There were no significant differences in MAP, HR, and SpO2 among groups. Compared to group A, NRS scores of groups B and C were lower dur- ing the analgesia （ P 〈0. 01 ）. Compared to group A, Ramsay sedation scores of groups B and C were higher at T1, and T2（ P 〈0. 01）. Compared to group A, Harris hip scores of groups B and C were higher at T3 , and T4 （ P 〈 0.01 ）. Compared to group C, adverse reactions of groups A and B were less during the analgesia （ P 〈 0. 01 ）. Compared to group A, the total number of press PCIA and dezocine amount were decreased in groups B and C （ P 〈 0. 01）. Conclusions The 0. 75 μg/kg sufentanil combined with 1.5 μg/kg right beauty holds the minimum for intravenous analgesia effect after hip arthroplasty and calm exactly satisfied, less adverse reaction, for PCIA ideal drug formula.
出处
《中国医师杂志》
CAS
2016年第2期236-239,共4页
Journal of Chinese Physician
