摘要
目的观察地佐辛联合腰方肌阻滞的多模式镇痛用于肾移植的围手术期效果评价。方法选取2019年1月至2021年12月中国人民解放军联勤保障部队第九二四医院收治的60例同种异体肾移植手术患者作为研究对象,采用随机数字表法分为多模式组与对照组,每组30例。多模式组麻醉诱导前30 min静脉注射地佐辛10 mg,超声引导下行术侧腰方肌阻滞效果满意后全身麻醉,对照组采用常规全身麻醉。比较拔喉罩即刻(T_(1))及拔喉罩后5 min(T_(2))、30 min(T_(3))、1 h(T_(4))、2 h(T_(5))的平均动脉压(mean arterial pressure,MAP)、心率(heart rate,HR)及脉搏氧饱和度(percutaneous arterial oxygen saturation,SpO_(2))、视觉模拟评分法(visual analogue score,VAS)评分、Ramsay镇静评分和躁动-镇静程度评估表(richmond agitation-sedation scale,RASS)评分及舒芬太尼用量、瑞芬太尼用量、手术时间、意识恢复时间、麻醉后监测治疗室(postanesthesia care unit,PACU)时间。结果多模式组意识恢复时间、PACU时间均短于对照组,瑞芬太尼用量少于对照组,差异有统计学意义(P<0.05)。T_(2)、T_(3)、T_(4)、T_(5),多模式组VAS评分、RASS评分均低于对照组,Ramsay评分高于对照组,差异有统计学意义(P<0.05)。T_(2)、T_(3)、T_(4)、T_(5),多模式组MAP、HR均低于对照组,差异有统计学意义(P<0.05)。结论多模式理念下地佐辛复合前路腰方肌阻滞镇痛安全有效,能通过不同的作用位点阻断疼痛信息的传递,减轻患者机体应激反应。
Objective To observe the effectiveness of multi-modal analgesia combining dezocine with quadratus lumborum block for renal transplantation recipients during their peri-operative period.Methods 60 patients who underwent homogeneity variant renal transplantation in the 924th Hospital of Joint Logistic Support Force of PLA from January 2019 to December 2021 were selected as the research subjects,and they were divided into the multi-mode group and the control group according the random table method,with 30 cases in each group.In the multi-mode group,10 mg of dezocine was injected intravenously 30 min before anesthesia induction,and general anesthesia was administered after the effect of ultrasound-guided intraoperative quadratus lumborum block was satisfied,the control group was given conventional general anesthesia.Mean arterial pressure(MAP)and heart rate(HR),percutaneous arterial oxygen saturation(SpO_(2)),visual analogue score(VAS)score,Ramsay sedation score and richmond agitation-sedation scale(RASS)score immediately remove the laryngeal mask(T_(1))and 5 min(T_(2)),30 min(T 3),1h(T_(4))and 2 h(T_(5))after laryngeal mask withdrawal and Sufentanil dosage,remifentanil dosage,operation time,consciousness recovery time,postanesthesia care unit(PACU)time after anesthesia were compared between the two groups.Results The consciousness recovery time and PACU time in the multi-mode group were shorter than those in the control group,and the dosage of remifentanil was less than that in the control group,the differences were statistically significant(P<0.05).At T_(2),T 3,T_(4) and T_(5),the VAS and RASS scores in the multi-mode group were significantly lower than those in the control group,and the Ramsay scores were significantly higher than those in the control group(P<0.05).T_(2),T 3,T_(4) and T_(5),the MAP and HR in the multi-mode group group were lower than those in the control group,and the difference was statistically significant(P<0.05).Conclusion Multi-modal analgesia combined with anterior quadratus lumborum block analgesia under the multi-mode concept is safe and effective,which can block the transmission of pain information through different action sites and reduce the stress response of patients.
作者
伍江明
袁峰
唐兢
李洪
王东
周汝虹
曾长洲
晏强
WU Jiangming;YUAN Feng;TANG Jing;LI Hong;WANG Dong;ZHOU Ruhong;ZENG Changzhou;YAN Qiang(Department of Anesthesiology,924th Hospital of Joint Logistic Support Force of PLA,Guilin,Guangxi,541002,China;Kidney Disease Specialist Center,924th Hospital of Joint Logistic Support Force of PLA,Guilin,Guangxi,541002,China)
出处
《当代医学》
2025年第4期130-134,共5页
Contemporary Medicine
基金
广西壮族自治区卫生健康委员会计划课题(Z-C20221049)。
关键词
多模式镇痛
地佐辛
腰方肌阻滞
肾移植
Multi-modal analgesia
Dezocine
Quadratus lumborum block
Kidney transplantation
