丁丙诺啡对老年急腹症手术患者的镇痛作用

发布时间：2018-03-23 00:33

  本文选题：急腹症　切入点：丁丙诺啡　出处：《中国老年学杂志》2017年15期 　论文类型：期刊论文

【摘要】：目的探讨丁丙诺啡对老年急腹症手术患者的镇痛作用。方法将82例老年急腹症拟行手术治疗的患者,利用随机数字表法分为观察组和对照组。对照组给予常规麻醉,观察组在常规麻醉的基础上给予丁丙诺啡超前镇痛。对比两组术中生命体征指标变化、术后疼痛评分、血清C反应蛋白(CRP)、皮质醇(Cor)浓度变化,并对比两组术后静脉自控镇痛药物用量及不良反应发生情况。结果插管后即刻和插管5 min后对照组平均动脉压(MAP)、心率(HR)均明显升高(P0.05),动脉血氧饱和度(SpO_2)水平均显著降低(P0.05),而观察组均无显著变化(P0.05);插管后即刻和插管5 min后观察组MAP、HR均明显低于对照组(P0.05),而SpO_2明显高于对照组(P0.05);两组疼痛评分均随着时间的推移不断降低(P0.05),且各时刻观察组的评分均明显低于对照组(P0.05);术后6 h和术后12 h两组血清CRP、Cor浓度均显著升高(P0.05),但观察组血清CRP、Cor浓度均明显低于对照组(P0.05);观察组术后静脉自控镇痛药物用量明显少于对照组(P0.05),两组术后均无明显不良反应。结论对老年急腹症手术患者实施丁丙诺啡超前镇痛并不会导致生命体征指标变化且不增加不良反应,可有效减轻术后疼痛和手术应激反应。
[Abstract]:Objective to investigate the analgesic effect of buprenorphine on elderly patients with acute abdomen. Methods Eighty-two elderly patients with acute abdomen were divided into observation group and control group by random digital table. In the observation group, buprenorphine preemptive analgesia was given on the basis of routine anesthesia. The changes of vital signs, postoperative pain scores, serum C-reactive protein (CRP) and cortisol Corn were compared between the two groups. Results immediately after intubation and 5 min after intubation, the mean arterial pressure (map) and heart rate (HR) in the control group were significantly higher than those in the control group (P 0.05), and the level of arterial oxygen saturation (SPO _ 2) was significantly higher than that in the control group. After intubation and 5 min after intubation, the HR of MAPP in observation group was significantly lower than that in control group (P 0.05), while SpO_2 was significantly higher than that in control group (P 0.05). The pain scores of both groups were decreased with time, and each group was significantly lower than that of control group (P 0.05). The score of the observation group was significantly lower than that of the control group (P0.05), the serum CRPnCor concentration of the two groups was significantly higher than that of the control group at 6 h and 12 h postoperatively, but the concentration of CRPnCor in the observation group was significantly lower than that in the control group. The dosage of buprenorphine was significantly lower than that of the control group (P 0.05), and there was no significant adverse reaction in both groups. Conclusion buprenorphine preemptive analgesia in elderly patients with acute abdominal surgery does not cause changes in vital signs and does not increase adverse reactions. It can effectively relieve postoperative pain and stress response.
【作者单位】： 沈阳市红十字会医院麻醉科;
【分类号】：R614
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本文编号：1651128