【摘要】 目的:探讨右美托咪定联合芬太尼对骨科手术患者术后镇痛效果及血流动力学的影响。方法:80例拟行骨科手术患者随机分为观察组（40例）和对照组（40例）。观察组患者给予盐酸右美托咪定注射液+枸橼酸芬太尼注射液自控镇痛（PCA）,镇痛维持48 h。对照组患者给予枸橼酸芬太尼注射液PCA,镇痛维持48 h。观察两组患者从应用多功能监护仪到连接PCA时（T₀）、连接后12 h（T₁）、48 h（T₂）的平均动脉压（MAP）、血氧饱和度（SpO₂）、心率（HR）、疼痛视觉模拟（VAS）评分及不良反应发生情况。结果:T₀时,两组患者VAS评分比较,差异均无统计学意义（P>0.05）。T_1-2时,两组患者VAS评分均显著高于同组T₀时,T₁显著高于T₂,但观察组显著低于对照组同期,差异均有统计学意义（P<0.05）。两组患者不同时间点的MAP、SpO₂、HR比较,差异均无统计学意义（P>0.05）。观察组患者呼吸抑制、剧痛、恶心呕吐、低血压发生率均显著低于对照组,差异均有统计学意义（P<0.05）。结论:右美托咪定联合芬太尼用于骨科手术患者术后的镇痛效果显著,对血流动力学无影响,且安全性较好。更多还原

【Abstract】 OBJECTIVE:To investigate the influence of dexmedetomidine combined with fentanyl on analgesic effects and hemodynamics of orthopedics patients after surgery. METHODS:A total of 80 patients undergoing orthopedics surgery were randomly divided into observation group（40 cases）and control group（40 cases）. Observation group was given patient-controlled analgesia（PCA）of Dexmedetomidine hydrochloride injection+Fentanyl citrate injection,maintaining analgesia for 48 h. Control group was given PCA of Fentanyl citrate injection,maintaining analgesia for 48 h. The MAP,SpO₂,HR,VAS and the occurrence of ADR were observed in 2 groups from the application of multi-function monitor to connecting to PCA（T₀）,12 h after connecting（T₁）and 48 h after connecting（T₂）. RESULTS:At T₀,there was no statistical significance in VAS score between 2 groups（P>0.05）.VAS scores of 2 groups at T_1-2were significantly higher than at T₀. Those of 2 groups at T₁ were significantly higher than at T₂;but the observation group was significantly lower than the control group,with statistical significance（P<0.05）. There was no statistical significance in MAP,SpO₂ or HR between 2 groups at different time points（P>0.05）. The incidence of respiratory depression,sharp pain,nausea and vomiting,hypotension in observation group were significantly lower than control group,with statistical significance（P<0.05）. CONCLUSIONS:Dexmedetomidine combined with fentanyl show significant analgesic effect after orthopedics surgery,and have no effect on hemodynamics with good safety.更多还原