帕金森病患者行下腹部手术术后镇痛效果的临床观察

发布时间：2018-06-10 06:28

本文选题：帕金森病 + 术后镇痛　；参考：《临床麻醉学杂志》2015年11期

【摘要】：目的观察帕金森病患者行下腹部手术术后镇痛效果。方法选择在全身麻醉下行开放性下腹部手术的帕金森病患者21例(PD组)和在全身麻醉下行开放性下腹部手术的非帕金森病患者27例(NP组),于术前24h分别采用汉密尔顿抑郁量表(HAMD-17)和VAS评分测评患者抑郁和疼痛水平。两组均采用全凭静脉麻醉,术毕前10 min静注芬太尼2μg/kg、托烷司琼2 mg。PCIA泵配方为舒芬太尼200μg+地佐辛15mg+托烷司琼6mg,使用生理盐水稀释成150ml,参数设置为背景剂量2 ml/h,冲击剂量0.5 ml,锁定15 min。记录术后4、24、48h静息状态的VAS、Ramsay评分和PCIA泵按压次数及术后48hHAMD-17评分。结果术毕~术后4hPD组PCIA泵按压次数明显少于NP组(P0.05)。术后4~48hPD组PCIA泵按压次数明显多于NP组(P0.05)。PD组术后24、48h时VAS评分,术后4、24、48h时Ramsay评分明显高于NP组(P0.05)。术后48hPD组HAMD-17评分明显高于NP组(P0.05)。PD组术后恶心、呕吐、嗜睡等不良反应发生率明显高于NP组(P0.05)。线性回归分析显示帕金森病、VAS评分均为术后48h HAMD-17显著预测变量(P0.05)。结论帕金森病患者行下腹部手术术后疼痛、镇静程度、抑郁水平均高于非帕金森病患者,且镇痛不良反应亦多于非帕金森病患者。
[Abstract]:Objective to observe the effect of postoperative analgesia in patients with Parkinson's disease undergoing lower abdominal surgery. Methods Twenty-one patients with Parkinson's disease undergoing open lower abdominal surgery under general anesthesia and 27 patients with non-Parkinson 's disease undergoing open lower abdominal surgery under general anesthesia were treated with Hanmi at 24 hours before operation. The LSD-17) and VAS scores were used to measure depression and pain levels in patients. Both groups were treated with total intravenous anesthesia. 10 min before operation, fentanyl 2 渭 g / kg, tropisetron 2 mg 路PCIA pump formulation: sufentanil 200 渭 g 15mg tropisetron 6 mg, diluted to 150 ml with normal saline, parameter set as background dose 2 ml / h, impact dose 0.5 ml, lock 15 min. The Vasher Ramsay score, PCIA pump press times and 48 h HAMD-17 score were recorded. Results from the end of operation to 4 hours after operation, the number of pump pressing in PD group was significantly less than that in NP group (P 0.05). The pressure times of PCIA pump in PD group were significantly higher than that in NP group (P 0.05). The VAS score in PD group was significantly higher than that in NP group (P 0.05) at 48 h, and the Ramsay score at 48 h after operation was significantly higher than that in NP group (P 0.05). The score of HAMD-17 in PD group was significantly higher than that in NP group (P 0.05). The incidence of postoperative nausea, vomiting and somnolence in PD group was significantly higher than that in NP group (P 0.05). Linear regression analysis showed that the VAS scores of Parkinson's disease patients were significant predictors of HAMD-17 at 48 hours postoperatively (P 0.05). Conclusion pain, sedation and depression in patients with Parkinson's disease after lower abdominal surgery are higher than those in patients with non-Parkinson 's disease, and the adverse effects of analgesia are more than those in patients with non-Parkinson 's disease.
【作者单位】：河北医科大学附属哈励逊国际和平医院麻醉科;河北医科大学附属哈励逊国际和平医院疼痛科;河北医科大学附属哈励逊国际和平医院神经内科;
【分类号】：R614

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