氢吗啡酮联合舒芬太尼用于脊柱手术的超前镇痛效果评价

发布时间：2018-03-20 23:00

本文选题：氢吗啡酮　切入点：舒芬太尼　出处：《广东医学》2017年06期 　论文类型：期刊论文

【摘要】：目的探讨氢吗啡酮联合舒芬太尼用于骨科脊柱手术超前镇痛的临床应用效果评价。方法选取需择期接受脊柱手术治疗患者120例,随机分成4组(n=30),于手术开始前10 min,H1组:静脉给予20μg/kg氢吗啡酮;H2组:静脉给予30μg/kg氢吗啡酮;H3组:静脉给予40μg/kg氢吗啡酮;对照组(C组):静脉给予相同剂量的生理盐水。各组患者缝皮前10 min,均追加给予0.1μg/kg舒芬太尼。术中麻醉前(S1)、手术开始前10 min(S2)、手术开始时(S3)、手术开始后10 min(S4)和手术开始后30 min(S5)监测并记录患者生命体征(心率、血压和血氧饱和度);术后分别于拔除气管导管后10 min(T1)、30 min(T2)、1 h(T3)、2 h(T4)、4 h(T5)、6 h(T6)、12 h(T7)、24 h(T8)随访记录VAS评分和术后不良反应。结果与其他3组比较,对照组S3和S4时点的心率和血压明显升高(P0.05);各时点,H1组、H2组和H3组组间比较,差异无统计学意义(P0.05)。T1~T5时点,H1组、H2组和H3组分别与C组比较,VAS评分明显低于C组(P0.05);T6和T7时点,H1组、H2组和H3组分别与C组比较,差异无统计学意义(P0.05)。对照组术后躁动率明显升高,H3组皮肤瘙痒率明显升高。结论术中静脉给药20~40μg/kg氢吗啡酮联合舒芬太尼用于脊柱手术超前镇痛,能取得术中和术后较好的镇痛效果,而30μg/kg剂量的氢吗啡酮既能取得较良好的镇痛效果,又具有较少的不良反应,推荐使用。
[Abstract]:Objective to evaluate the clinical efficacy of hydromorphone combined with sufentanil for preemptive analgesia in orthopedic spinal surgery. Four groups were randomly divided into 4 groups: group H _ 1: 20 渭 g / kg / kg hydromorphine and H _ 2: 30 渭 g / kg / kg / h ~ (-1) H _ (3): 40 渭 g / kg / kg / h ~ (-1) hydromorphone; The patients in each group were given 0.1 渭 g / kg sufentanil 10 min before suture, 10 min before operation, 10 min before operation, 10 min before operation, 10 min after operation, 10 min after operation and 10 min after operation. The vital signs (heart rate) were monitored and recorded 30 min after the onset. VAS scores and postoperative adverse reactions were recorded 10 min after extubation of trachea catheter and 30 min after extubation of trachea catheter, respectively, 10 min after extubation and 30 min after extubation of trachea catheter, and the results were compared with that of the other three groups, and the results were compared with those of the other three groups, and the VAS scores and postoperative adverse reactions were recorded at 10 min after the removal of trachea catheter, and the results were compared with those of the other three groups. The heart rate and blood pressure in the control group were significantly higher than those in the control group at S3 and S4. There was no significant difference in VAS scores between group H _ 2 and group H _ 3 at the time point of P0.05, T1 and T5. The scores of VAS in group H _ 2 and H _ 3 were significantly lower than those in group C and group C, respectively, compared with those in group H _ 2 and group H _ 3 at the time point of P 0.05, T _ 1 and T _ 7, respectively. There was no significant difference (P 0.05). The restlessness rate in the control group was significantly higher than that in the H3 group. Conclusion the intraoperative intravenous administration of 2040 渭 g / kg hydromorphone combined with sufentanil was used for preemptive analgesia in spinal surgery. The analgesic effect was better both during and after operation, and 30 渭 g / kg hydromorphine could not only obtain better analgesic effect, but also had less adverse reactions. Therefore, it is recommended to use it.
【作者单位】：武汉市红十字会医院麻醉科;
【分类号】：R614

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