摘要
目的 探讨在手术麻醉中采用不同剂量的右美托咪定对患者术后镇痛的应用效果。方法 选取2017年1月1日—2021年12月31日在常州市中医医院进行全膝关节置换术的患者,共有120例纳入研究中。根据术中右美托咪定使用剂量分成4组,每组各纳入30例患者,所有患者均采用舒芬太尼,对照组以舒芬太尼为主进行镇痛,在此基础上其余3组分别采用右美托咪定加强镇痛,使用剂量分别是0.1、0.15、0.2μg/(kg·h),命名为低剂量组、中剂量组以及高剂量组,重点观察术后不同时间点患者的镇痛效果、镇静效果以及不良反应发生情况。结果 在镇痛方面,中剂量组与高剂量组在术后不同时间段镇痛评分均显著低于对照组与低剂量组,差异有统计学意义(P <0.05);在镇静方面,低剂量组、中剂量组、高剂量组术后不同时间段镇静评分均高于对照组,差异有统计学意义(P <0.05);同期相比,高剂量组镇静评分高于低剂量组与中剂量组,差异有统计学意义(P <0.05)。在不良反应发生率方面,中剂量组不良反应发生率最低,但组间对比差异无统计学意义(P> 0.05)。结论 综合评价,在外科手术后对患者使用舒芬太尼镇痛的基础上增加0.15μg/(kg·h)右美托咪定镇痛效果更佳,且安全性较高。
Objective To investigate the effect of different doses of dexmedetomidine on postoperative analgesia in surgical anesthesia.Methods A total of 120 patients who underwent total knee arthroplasty in Changzhou Hospital of Traditional Chinese Medicine from January 1,2017 to December 31,2021 were included in the study.According to the intraoperative dose of dexmedetomidine,they were divided into four groups,with 30 patients in each group.All patients were treated with sufentanil,and the control group was mainly treated with sufentanil for analgesia.On this basis,the other three groups were treated with dexmedetomidine for enhanced analgesia,with the dosage of 0.1,0.15,0.2 μg/(kg·h) respectively,named as the low dose group,the medium dose group and the high dose group.The analgesic effect,sedative effect and adverse reactions of patients at different time points after operation were observed.Results In terms of analgesia,the analgesic scores of the middle dose group and the high dose group were significantly lower than those of the control group and the low dose group at different time after operation,the differences were statistically significant(P < 0.05).In terms of sedation,the sedation scores of the low dose group,the medium dose group and the high dose group were higher than those of the control group,the differences were statistically significant(P <0.05).Compared with the same period,the sedation score of the high dose group was higher than that of the low dose group and the medium dose group,the differences were statistically significant(P < 0.05).In terms of the incidence of adverse reactions,the middle dose group had the lowest incidence of adverse reactions,but there was no statistical significance between the groups(P < 0.05).Conclusion Based on the comprehensive evaluation,the use of sufentanil for analgesia after surgery is increased by 0.15 μg/(kg·h) dexmedetomidine has better analgesic effect and higher safety.
作者
金娴冰
潘小燕
邹鲁
潘春英
商建飞
JIN Xianbing;PAN Xiaoyan;ZOU Lu;PAN Chunying;SHANG Jianfei(Department of Anesthesiology,Changzhou Hospital of Traditional Chinese Medicine,Changzhou Jiangsu 213000,China)
出处
《中国卫生标准管理》
2022年第20期119-123,共5页
China Health Standard Management
