摘要
目的探讨曲马多联合舒芬太尼在老年脊柱后路手术患者中的应用价值。方法在2018年1月~2020年1月以整群随机抽样法选入本院60例老年脊柱后路手术患者为研究对象,并随机分组。对照组(n=30)术中应用布托啡诺联合舒芬太尼进行麻醉,研究组(n=30)应用曲马多联合舒芬太尼进行麻醉。参考Ramsay镇静评分标准、视觉模拟评分法(VAS)评价患者脊柱后路手术后不同时间点的疼痛感、镇静程度差异,同时记录患者术后苏醒时间以及麻醉不良反应发生率。结果(1)研究组镇痛开始后6h、12h、24h和48h的Ramsay镇静评分均低于对照组(t=10.174、16.818、17.116、15.910,P均<0.001),而VAS评分组间比较,差异均无统计学意义(t=0.667、0.104、1.623、1.406,P均>0.05)。(2)研究组术后呼吸恢复时间、睁眼时间、拔管时间均短于对照组(t=1.870、2.129、5.033,P均<0.05);(3)研究组术后麻醉不良反应总发生率高于对照组(χ2=5.455,P=0.020)。结论曲马多联合舒芬太尼在老年脊柱后路手术患者中的应用价值显著,镇静效果良好,可促使患者早期苏醒,但不良反应发生率稍高,应慎重使用。
Objective To investigate the application value of tramadol combined with sufentanil in elderly patients undergoing spinal posterior approach surgery.Methods A total of 60 elderly patients admitted to our hospital undergoing spinal posterior approach surgery from January 2018 to January 2020 were selected by cluster random sampling method,and were randomly divided into the control group(n=30)and the study group(n=30).According to Ramsay sedation score standard and visual analogue scale(VAS),the differences of pain and sedation degree at different time points after spinal posterior approach surgery were evaluated.Meanwhile,the postoperative wake-up time and the incidence of anesthesia adverse reactions(ADRs)were recorded.Results(1)The Ramsay sedation scores of the study group at 6 hours,12 hours,24 hours and 48 hours after analgesia were lower than those of the control group(t=10.174,16.818,17.116,15.910,all P<0.001),but there was no statistically significant difference in VAS scores among the groups(t=0.667,0.104,1.623,1.406,all P>0.05).(2)The respiratory recovery time,eye opening time and extubation time in the study group were all shorter than those in the control group(t=1.870,2.129,5.033,all P<0.05).(3)The incidence of postoperative anesthesia ADRs in the study group was higher than that in the control group(χ2=5.455,P=0.020).Conclusion As for tramadol combined with sufentanil,there are significant application value in elderly patients undergoing spinal posterior approach surgery,which are of good sedative efficacy.Meanwhile,they can promote the early wake-up of patients.However,the incidence of ADRs is slightly higher,so they should be used with caution.
作者
韦程瀚
梁吉
WEI Chenghan;LIANG Ji(Department of Anesthesiology,the First People's Hospital of Nanning,Guangxi,Nanning 530022,China)
出处
《中国医药科学》
2020年第22期105-108,共4页
China Medicine And Pharmacy
关键词
曲马多
舒芬太尼
老年人
脊柱后路手术
镇静评分
疼痛
不良反应
Tramadol
Sufentanil
Elderly people
Spinal posterior approach surgery
Sedation score
Pain
Adverse reactions
