摘要
目的研究静脉注射氟比洛芬酯联合右美托咪定超前镇痛在高龄髋部手术中的临床应用效果。方法选取2016年1月—2018年12月在本院骨科行髋部手术的90例患者为研究对象,随机分成实验组、对照组A、对照组B,每组各30例。对照组A在麻醉前静脉注射氟比洛芬酯;对照组B在麻醉前静脉注射右美托咪定;实验组在麻醉前静脉注射氟比洛芬酯,同时给予右美托咪定,观察三组患者不同时间点的生命体征的变化;疼痛状况和舒适度评分;镇静情况评价; 24 h镇痛泵应用情况比较、镇痛治疗质量评价;患者不良反应情况。结果实验组患者在麻醉后的不同时间点RR、HR、MAP、Sp O2与麻醉前比较,变化无统计学意义(P>0.05),对照组A、对照组B患者麻醉后不同时间点RR、HR、MAP、Sp O2与麻醉前比较,RR、Sp O2变化无统计学意义(P>0.05),而HR、MAP与麻醉前比较,变化有统计学意义(P<0.05);实验组VAS评分明显低于对照组A和对照组B,差异有统计学意义(P<0.05);实验组BCS评分均高于对照组A和对照组B,差异有统计学意义(P<0.05);实验组Ramsa镇静评分均低于对照组A和对照组B,差异有统计学意义(P<0.05);实验组患者术后24 h芬太尼用量和镇痛泵按压次数明显少于对照组A和对照组B,差异有统计学意义(P<0.05);患者术后镇痛质量评价,实验组明显高于对照组A和对照组B,差异具有统计学意义(P<0.05);实验组患者术后不良反应率明显少于对照组A和对照组B,差异有统计学意义(P<0.05)。结论高龄髋部手术预注氟比洛芬酯联合右美托咪定能够显著降低心率及动脉压,抑制术后应激反应,提高超前镇痛效果,减少不良反应,效果显著,值得推广。
Objective To study the clinical application effect of flurbiprofen axetil intravenously injection combined with dexmedetomidine in the preemptive analgesia for elderly patients received hip surgeries.Methods Ninety elderly patients,received hip surgeries in the hospital during January 2016 and December 2018,were selected as study subjects,and they were randomly divided into experimental group,control group A,and control group B,30 cases in each.Patients in group A received intravenous injection of Flurbiprofen Axetil before anesthetization.Patients in control group B were injected with Dexmedetomidine before anesthetization.For the experimental group,patients were injected with Flurbiprofen Axetil and Dexmedetomidine before anesthetization.The vital signs of the patients at different times,the conditions of pain and comfort scores,judgment of the sedative situation,the application of the 24-hour Analgesia pump and the quality of analgesia therapy,and the side effects of the three groups were compared.Results Compared with those before anesthetization,the changes of RR,HR,MAP,and Sp O2 at different times in experimental group were not statistically significant(P>0.05).For the control group A and B,the changes of RR and Sp O2 are not of statistical significance(P>0.05).However,the changes of HR and MAP are of statistically significance(P<0.05).The VAS score of the experimental group was obviously lower than the control group A and B,the differences were statistically significant(P<0.05).The BCS score of the experimental group was obviously higher than the control group A and B,the differences were statistically significant(P<0.05).The Ramsa calm score of the experimental group was obviously lower than the control group A and B,the difference is of statistical significance(P<0.05).The quantity of Fentanyl used and press times of epidural analgesic tube in the 24 hours after the surgery were less than the group A and group B,the differences were of statistical significance(P<0.05).The pain-ease valuation of experimental group was obviously higher than control group A and B,the differences were of statistical significance(P<0.05).The side effects of experimental group were obviously less than the group A and B,the differences were of statistical significance(P<0.05).Conclusions Injection of Flurbiprofen Axetil and Dexmedetomidine before surgery could obviously reduce the heart rate and arterial pressure,effectively inhibit press response and improve the effects of preemptive analgesia,reduce the incidence of untoward effect.It should be promoted.
作者
汤健
黄杰锋
周志军
丰亮
TANG Jian(Department of anesthesiology,the second people's hospital of Nantong,Nantong,Jiangsu,226002,China)
出处
《齐齐哈尔医学院学报》
2019年第6期686-690,共5页
Journal of Qiqihar Medical University
基金
2014年度南通市市级科研项目(HS149046)
关键词
氟比洛芬酯
右美托咪定
超前镇痛
高龄
髋部手术
Flurbiprofen Axetil
Dexmedetomidine
Preemptive analgesia
Elderly patients
Hip surgery
作者简介
通信作者:汤健,Email:1262736616@qq.com
