摘要
目的观察盐酸右美托咪定复合舒芬太尼用于老年患者术后自控静脉镇痛(PCIA)的有效性和安全性.方法所有患者手术均采用咪达唑仑、顺式阿曲库铵、丙泊酚、芬太尼行麻醉诱导,顺式阿曲库铵、芬太尼与丙泊酚维持麻醉,术后患者随机分为A,B,C 3组,使用PCA泵镇痛;分别记录苏醒后(T0),术后4 h(T1),8 h(T2),12 h(T3),24 h(T4)VAS评分;Ramsay镇静评分;术后不同时点PCA按压次数;24 h舒芬太尼累计用量;镇痛期间低血压等不良反应的发生情况.结果术后24 h内VAS评分A,B组高于C组(P<0.05);Ramsay镇静评分:A,B组低于C组(P<0.05);24 h镇痛泵的总按压次数A组高于B组(P<0.05),B组高于C组(P<0.05);与术前相比,A组术后血压、心率变化不明显,而B,C两组术后血压、心率下降(P<0.05);3组患者术后均无呼吸抑制和镇静过度等不良反应(P>0.05),恶心的不良反应发生率B,C组明显少于A组(P<0.05).结论盐酸右美托咪定复合舒芬太尼用于老年患者术后自控静脉镇痛安全、有效.
Objective To observe the effect and safety of dexmedetomidine combined with sufentanil in postoperative patient-controlled intravenous analgesia （PCIA） in elderly patients. Method All operations were performed by using the anesthesia induction with midazolam, eis-atraeurium, propofol and fentanyl, and the maintenance anesthesia with cis-atracurium, fentanyl and propofol . The patients were randomly divided into three groups after the operation,that is,group A,group B and group C, and all of them were treated with PCA pump. VAS scores,ramsay sedation scores at 0 hour （T0） after awakening,and at 4 h （ T1 ） ,8 h（ T2 ）, 12 h（ T3 ） ,24 h （T4） after operation, postoperative pressing PCA pump time times at different time points,24-hour cumulative dosage of sufentanil, postoperative hypotension and other adverse reactions during the analgesia were observed and recorded. Results VAS scores in group A and B within 24 hours after operation were higher than those in group C （ P 〈 0.05 ）. Ramsay sedation scores in group A and B were lower than those in group C （P 〈 0.05 ）. The total pressing times of analgesia pump within 24 hours after the operation in group A were more than those in group B （P 〈 0.05 ）, and those in group B were more than group C （ P 〈 0.05 ）. Compared with the pre-operation, postoperative blood pressure and heart rate in group A did not change obviously, but those in group B and C decreased significantly （ P 〈 0.05 ） ; patients in three groups all had no respiratory depression and over sedation （ P 〈 0.05 ）, and the incidence of nausea in group B and C was significantly less than that in group A （ P 〈 0.05 ）. Conclusion The application of dexmedetomidine combined with sufentanil for postoperative PCIA in elderly patients should be safe and efficacious.
出处
《北华大学学报（自然科学版）》
CAS
2014年第1期58-62,共5页
Journal of Beihua University（Natural Science）
基金
山东省科技发展计划项目(2012GSF11833)
