摘要
目的观察小剂量地佐辛用于髋关节置换术术后静脉镇痛对复苏质量的影响。方法选取本院2017年1月至2018年5月收治的88例择期髋关节置换术患者,按随机数表法分为低剂量组与高剂量组,每组44例。两组均采取椎管内麻醉,术后予罗哌卡因切口浸润+PCIA。低剂量组PCIA配方:地佐辛0.4 mg/kg+昂丹司琼4 mg+地塞米松10 mg+生理盐水稀释至100 ml;高剂量组PCIA配方:地佐辛0.8 mg/kg+昂丹司琼4 mg+地塞米松10 mg+生理盐水稀释至100 ml。比较两组术后2、4、8、24、48 h时的疼痛程度[视觉模拟评分法(VAS)]、镇静效果(Ramsay评分)、舒适度[舒适度评分(BCS)]、不良反应总发生率。结果两组术后8、24、48 h疼痛VAS评分均低于术后2 h时(P<0.05)。两组术后2～48 h的Ramsay评分约为1.5～3.5分,镇静效果满意;BCS评分均在2分以上,舒适度较高。两组不同时刻的疼痛VAS评分、Ramsay评分、BCS评分比较差异均无统计学意义(P>0.05)。低剂量组不良反应发生率低于高剂量组(11.36%vs.29.54%),差异有统计学意义(P<0.05)。结论小剂量(0.4 mg/kg)地佐辛用于髋关节置换术术后PCIA可满足患者镇痛与镇静需求,且不良反应少,复苏质量更理想。
Objective To observe the effect of low-dose dezocine on quality of resuscitation of analgesia after hip arthroplasty.Methods A total of 88 patients undergoing elective hip arthroplasty who were admitted to our hospital from January 2017 to May 2018 were enrolled and divided into low-dose group and high-dose group randomly,44 cases in each group.Both groups underwent spinal anesthesia and postoperative ropivacaine incision + PCIA.The PCIA formula of low-dose group was as follows:dezocine 0.4 mg/kg + ondansetron 4 mg + dexamethasone 10 mg + saline,diluted to 100 ml;the PCIA formula of high-dose group was as follows:dezocine 0.8 mg/kg + ondansetron 4 mg + dexamethasone 10 mg + saline,diluted to 100 ml.The pain degree,sedative effect and comfort degree were assessed by visual analog scale(VAS),Ramsay score and Bruggrmann Comfort Scale(BCS)at 2 h,4 h,8 h,24 h,and 48 h after surgery,and the overall incidence of adverse reactions were compared between the two groups.Results The VAS score of patients at 8 h,24 h and 48 h after operation was lower than that at 2 h after operation(P<0.05).The Ramsay score of patients at 2 ~ 48 h after operation was 1.5 ~ 3.5,and the sedative effect was satisfactory.The BCS scores of patients were all more than 2 points,and the comfort degree was high.There was no significant difference in VAS score,Ramsay score or BCS score at the different time points(P>0.05).The incidence of adverse reactions in lowdose group was lower than that in high-dose group(11.36% vs.29.54%,P<0.05).Conclusion Low-dose(0.4 mg/kg)dezocine for PCIA after hip replacement can meet the analgesic and sedative needs of patients,which has fewer adverse reactions,and the quality of recovery is good.
作者
黄雪梅
杜娟
冯海霞
HUANG Xue-mei;DU Juan;FENG Hai-xia(Department of Anesthesiology,Mianyang Central Hospital,Mianyang 621000,China)
出处
《实用药物与临床》
CAS
2019年第4期405-408,共4页
Practical Pharmacy and Clinical Remedies
关键词
髋关节置换术
地佐辛
复苏质量
镇痛
镇静
Hip arthroplasty
Dezocine
Quality of resuscitation
Analgesia
Sedation
