摘要
目的观察右美托咪啶对于神经外科术后镇痛及躁动的影响。方法 40例择期神经外科手术患者,随机分为右美托咪啶组(Y组)和传统组即舒芬太尼组(S组),关硬脑膜后分别连接术后镇痛泵,同时给予托烷司琼5 mg;Y组镇痛泵:2μg/kg右美托咪啶(最大量不超过200μg)+5 mg托烷司琼+生理盐水至200 ml,4 ml/h泵入;S组镇痛泵:2μg/kg舒芬太尼+5 mg托烷司琼+生理盐水至200 ml,4 ml/h泵入。观察连接镇痛泵前、连接镇痛泵后15、30 min血流动力学、呼吸恢复时间、睁眼时间、拔管时间、躁动是否发生及程度、恶心呕吐发生率,记录拔管后5、30 min时的躁动评分(RS)及镇静(RSS)评分,并记录术后6、12、24 h VAS、RS、RSS评分。结果连接术后镇痛泵前、连接镇痛泵后15、30 min两组比较,平均动脉压(MAP)、心率(HR)差异均无统计学意义。拔管时及拔管后15、30 min时S组MAP、HR均高于Y组(P<0.05),有统计学意义。拔管时及拔管后15、30 min时S组躁动(RS)评分显著高于Y组(P<0.05),镇静(RSS)评分显著低于Y组(P<0.05)。术后6、12、24 h S组躁动(RS)评分显著高于Y组(P<0.05),镇静(RSS)评分显著低于Y组(P<0.05)。拔管后S组恶心呕吐发生率为20.0%,显著高于Y组的5.00%(P<0.05)。结论右美托咪啶可安全用于神经外科术后镇痛,并有效预防躁动。
Objective To observe the effect of dexmedetomidine on postoperative analgesia and agitation. Methods Totally 40 patients undergoing Department of Neurosurgery surgery were randomly divided into dexmedetomidine group（ Y group） and sufentanil group（ group S）,postoperative analgesia pump are connected after closing the dura,Simultaneous giving tropisetron 5 mg; Group Y： 2 μg/kg dexmedetomidine（ maximum ≤200 μg） ＋ 5 mg tropisetron ＋ saline to 200 ml,pumping 4 ml/h; Group S： 2 μg/kg sufentanil ＋ 5 mg tropisetron saline to 200 ml,pumping 4 ml/h. To observe hemodynamics before connected the analgesia pump and after 15 min,30 min,respiratory recovery time,eye opening time,extubation time,occurrence and degree of restlessness,nausea and vomiting,extubation after 5 and 30 min agitation score（ RS） and Ramsay sedation score（ RSS）,were recorded. The VAS,RS,RSS score of 6 h,12 h,24 h after operation were recorded. Results There was no significant difference in MAP and HR between before connected the analgesia pump and after 15 min,30 min,MAP and HR in group S were higher than those in group Y at extubation and15 min and 30 min after extubation（ P 〈0. 05）. The RS score of S group was significantly higher than that of Y group at 15 and 30 min after extubation and RSS score was significantly lower than that in group（ P 〈0. 05）. The RS score of S group was significantly higher than the Y group at 6、12、24 h after operation and RSS score was significantly lower than that in group Y（ P 〈0. 05）. The incidence of nausea and vomiting in group S was higher than that in group Y（ P〈 0. 05） after extubation. Conclusion Dexmedetomidine is a safe and effective drug in preventing postoperative analgesia and agitation in Department of neurosurgery.
出处
《医药论坛杂志》
2018年第1期56-58,共3页
Journal of Medical Forum
关键词
右美托咪啶
神经外科
术后镇痛
躁动
Dexmede tomidine
Department of neurosurgery
Postoperative analgesia
Agitation
