小剂量舒芬太尼复合右美托咪定用于下肢骨折手术腰硬联合麻醉前效果观察

发布时间：2018-05-19 20:38

本文选题：舒芬太尼 + 右美托咪啶　；参考：《山东医药》2015年17期

【摘要】：目的观察小剂量舒芬太尼复合右美托咪定用于下肢骨折手术腰硬联合麻醉前的效果。方法将90例下肢骨折手术患者随机分为观察组与对照组各45例。观察组入手术室后静脉注射0.1μg/kg的舒芬太尼,恒速泵注1μg/kg的右美托咪定(10 min),之后将患者搬运到手术床上摆放麻醉体位。对照组进入手术室后不给予任何药物即摆放麻醉体位。实施腰硬联合麻醉,穿刺间隙选择L3~4,腰麻药物为0.5%罗哌卡因2.0~2.5 m L,麻醉操作成功后将患者翻身平卧。比较两组患者入室时(T1)、给药后(T2)、搬运到手术床上后(T3)和侧卧时(T4)平均动脉压(MAP)、心率(HR)、血氧饱和度(Sp O2)、Ramsay镇静评分和疼痛视觉模拟评分(VAS评分)。结果与T1比较,观察组T2、T3、T4时MAP均降低(P均0.05),HR减慢(P0.05);对照组T3、T4时MAP明显升高(P0.05),HR增快(P0.05);与对照组比较,观察组T2、T3、T4时MAP、HR显著降低(P0.05)。与T1比较,T3、T4时Ramsay评分显著增高(P0.05),VAS评分显著降低(P0.05)。结论下肢骨折手术在行腰硬联合麻醉前应用小剂量舒芬太尼复合右美托咪定可有效缓解患者的焦虑,减轻摆放体位时疼痛,有利于更好的实施麻醉。
[Abstract]:Objective to observe the effect of low dose sufentanil combined with dexmetomidine before spinal epidural anesthesia for lower extremity fracture. Methods 90 patients with lower extremity fracture were randomly divided into observation group and control group. In the observation group, 0.1 渭 g/kg sufentanil was injected intravenously into the operating room, and 1 渭 g/kg dexmetidine was injected into the constant velocity pump for 10 mins. The patients were then transferred to the operation bed and placed in anaesthesia position. The control group was placed in anaesthetic position without any medication after entering the operating room. Combined spinal-epidural anesthesia was performed. L3C4 was selected as the puncture space, and 0.5% ropivacaine was used as 2.0-2.5 mL. The patient was turned over on his back after the anesthesia was successfully performed. The mean arterial pressure (MAPP), heart rate (HRP), blood oxygen saturation (SPA), Ramsay sedation score and pain visual analogue score (VAS) were compared between the two groups. Results compared with T1, the MAP of the observation group was lower than that of the control group (P < 0.05), the MAP of the control group was significantly higher than that of the control group (P < 0.05), and that of the observation group was significantly lower than that of the control group at T _ (2) T _ (3) T _ (3) T _ (4) and P _ (0.05) (P < 0.05). Compared with T1, Ramsay score increased significantly at T3 + T4 and decreased significantly (P 0.05). Conclusion low dose sufentanil combined with dexmetomidine before surgery for lower extremity fracture can effectively relieve anxiety, relieve pain in posture, and be beneficial to better anaesthesia.
【作者单位】：淄博市临淄区人民医院;
【分类号】：R614

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