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右美托咪定联合羟考酮多模式镇痛在脊柱侧弯矫形术中的应用价值 被引量:7

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摘要 目的探讨右美托咪定联合羟考酮多模式镇痛在脊柱侧弯矫形术中的应用价值。方法将40例行脊柱侧弯矫形术患者随机分为观察组、对照组各20例,对照组不使用右美托咪定,术毕前30 min泵注羟考酮0.08 mg/kg,术后仅采用舒芬太尼2μg/kg镇痛;观察组采用多模式镇痛:麻醉诱导前10 min静注右美托咪定0.5μg/kg,术中予以右美托咪定0.15μg/(kg·h)+羟考酮0.04 mg/kg持续泵注至手术缝皮时停止药物输注,术后予以右美托咪定1.0μg/(kg·h)复合舒芬太尼2μg/kg镇痛。记录2组复苏情况及麻醉诱导前(t 0)、拔管前3 min(t 1)、拔管后3 min(t 2)、拔管后5 min(t 3)平均动脉压(MAP)、心率(HR)与拔管后30 min内Ramsay镇静评分、疼痛视觉模拟评分(VAS)、术后并发症发生情况。结果观察组苏醒时间、拔管时间、咳呛评分、唤醒质量评分明显短/低于对照组(P均<0.05);观察组t 1~t 3时MAP、HR均明显低于对照组(P均<0.05);观察组拔管后10 min、20 min Ramsay镇静评分明显高于对照组(P均<0.05),观察组拔管后30 min VAS评分明显低于对照组(P<0.05);观察组术后1 d急性肾损伤发生率明显低于对照组(P<0.05)。结论右美托咪定联合羟考酮多模式镇痛用于脊柱侧弯矫形术中,可明显改善患者苏醒质量,减少血流动力学波动,同时提高术后镇痛镇静效果,并发症少。
作者 刘倩 祖翠华
出处 《现代中西医结合杂志》 CAS 2019年第35期3956-3959,共4页 Modern Journal of Integrated Traditional Chinese and Western Medicine
作者简介 通信作者:祖翠华,E-mail:154740840@qq.com。
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