【摘要】 目的:观察不同剂量的右美托咪定(Dexmedetomidine,DEX)对于脊柱手术患者术后自控镇痛(Patient-Controlled Analgesia,PCA)效果的影响。方法:将90例全身麻醉下行择期脊柱手术的患者,随机分为3组,每组30例。术后,给予各组患者静脉自控镇痛,各组镇痛泵药物配方分别为:A组:氟比洛芬酯(Flurbiprofen Axetil,FLA)2.5 mg/kg+地佐辛(Dezocine,DEZ)0.6 mg/kg+帕洛诺司琼(Palonosetron,PAL)0.01 mg/kg;B组:DEX(4.0μg/kg)+DEZ(0.6 mg/kg)+PAL(0.01 mg/kg);C组:DEX(6.0μg/kg)+DEZ(0.6mg/kg)+PAL(0.01 mg/kg)。在术后2、6、12、24和48 h,分别观察和比较患者的视觉疼痛评分(Visual Analogue Scale,VAS)、Ramsay镇静评分、自控镇痛按压次数和不良反应的发生情况。结果:各组患者术后2、6、12、24和48 h的VAS评分比较差异无统计学意义(P>0.05)。与A组比,B组和C组自控镇痛总按压次数和恶心呕吐的发生率均显著降低(P<0.05),而Ramsay镇静评分显著升高(P<0.01)。与B组比,C组患者在术后12 h和24 h的Ramsay镇静评分显著升高(P<0.05)。结论:在脊柱患者术后自控镇痛中,使用DEX(4.0μg/kg)联用+DEZ+PAL的镇痛方案可产生较好的镇痛和镇静效果,术后恶心呕吐发生率也更低。更多还原

【Abstract】 Objective: To observe the analgesic effects of different doses of dexmedetomidine(DEX) combined with dezocine(DEZ) on the patients undergoing spine operation. Methods: Ninety cases of patients undergoing spinal surgery were randomly divided into three groups. Patients of group A received flurbiprofen axetil(FLA) of 2.5 mg/kg,dezocine(DEZ) of 0.6 mg/kg plus palonosetron(PAL) of 0.01 mg/kg for postoperative analgesia. Patients of group B received dexmedetomidine(DEX) of 4.0 μg/kg, DEX of 0.6 mg/kg plus PAL of 0.01 mg/kg. Patients of group C received DEX of 6.0 μg/kg,DEZ of 0.6 mg/kg plus PAL of 0.01 mg/kg. The visual analogue scale(VAS) and Ramsay sedation scores were recorded at 2, 4,6, 12, 24 and 48 h after operation. The effective pressing times, total times of patient-controlled analgesia and incidence of adverse effects were also assessed. Results: There was no statistical difference in the VAS score among the three groups(P>0.05). Compared with group A, the total times of Patient-controlled analgesia and incidence of nausea and vomiting in the group B and group C were obviously lower(P<0.05), and Ramsay scores was significantly higher in the group B and group C(P<0.05). Compared with group B, the Ramsay scores were higher at 12 h and 24 h in the group B and group C(P<0.05).Conclusion: In the spine operation undergoing spine operation, DEX(4.0 μg/kg)+DEZ+PAL could achieve a better analgesic and sedative effects with low incidence of nausea and vomiting.更多还原