两种联合麻醉方案用于行择期腰椎手术患者临床对比研究  

Clinical Comparative Study of Two Combined Anesthetic Protocols in Patients Undergoing Elective Lumbar Surgery

作　　者：谭首鹏[1] 杨川[1] 张玉荣[1] 陈贤华[1] 何丽云[1] 贾绍茂 敬亮 Tan Shoupeng;Yang Chuan;Zhang Yurong(Department of Anesthesiology,Second People＇s Hospital of Guangyuan City,Guangyuan,Sichuan 628000,China)

机构地区：[1]广元市第二人民医院麻醉科,四川广元628000

出　　处：《四川医学》2018年第8期932-935,共4页Sichuan Medical Journal

摘　　要：目的探讨帕瑞昔布钠分别联合舒芬太尼和地佐辛对行择期腰椎手术患者苏醒质量及不良反应的影响。方法研究对象选取我院2015年5月至2017年5月收治行择期腰椎手术患者共100例,以随机数字表法分为A组(50例)和B组(50例),分别采用帕瑞昔布钠联合舒芬太尼和地佐辛方案应用,比较两组患者自主呼吸恢复时间、意识恢复时间、拔管时间、不同时间点HR、MAP、SpO_2、VAS评分、Ramsay镇静评分、术后躁动评分及不良反应发生率。结果 B组患自主呼吸恢复时间和意识恢复时间均显著短于A组(P<0. 05);两组患者拔管时间比较差异无统计学意义(P>0. 05);两组患者麻醉前后HR、MAP及SpO_2水平比较差异无统计学意义(P>0. 05);两组患者麻醉前后VAS评分和Ramsay镇静评分比较差异无统计学意义(P>0. 05);两组患者术后躁动评分比较差异无统计学意义(p>0. 05); B组患者不良反应发生率显著低于A组(P<0. 05)。结论帕瑞昔布钠分别联合舒芬太尼和地佐辛方案用于行择期腰椎手术患者在生命体征稳定性和苏醒质量方面效果相当,但地佐辛辅助应用有助于缩短自主呼吸和意识恢复时间,降低不良反应发生风险。Objective To investigate the effects of pareoxib sodium combined with sufentanil and dizosin on the recovery quality and adverse reactions of patients undergoing elective lumbar surgery.Methods A total of 100 patients undergoing elective lumbar surgery in our hospital from May 2015 to May 2017 were selected as study objects and divided into two groups： group A（ n =50） and group B（ n = 50） according to random digital table method.Paroxib sodium combined with sufentanil and dizosin were used in the two groups respectively. The time of spontaneous respiration recovery,consciousness recovery and extubation,the scores of HR、MAP、SpO_2、VAS、Ramsay sedation and postoperative restlessness at different time points and incidence of adverse reactions were compared between the two groups.Results The recovery time of spontaneous respiration and consciousness in group B were both significantly shorter than those in group A（ P〈0.05）; No significant difference in extubation time between the two groups（ P〉0.05）; No significant difference in HR、MAP and SPO_2 levels between the two groups before and after anesthesia（ P〉0.05）; No significant difference in VAS score and Ramsay sedation score between the two groups before and after anesthesia（ P〉0.05）; No significant difference in postoperative restlessness score between the two groups（ P〉0.05）; The incidence of adverse reactions in group B was significantly lower than that in group A（ P〈0.05）.Conclusion The efficacy of paroxib sodium combined with sufentanil and dizosin in patients undergoing elective lumbar surgery is comparable in terms of vital sign stability and recovery quality.However,the adjuvant use of dizosin can shorten the time of spontaneous respiration and consciousness recovery and reduce the risk of adverse reactions.

关 键 词：舒芬太尼 地佐辛 腰椎手术 苏醒质量 不良反应 

分 类 号：R614.2[医药卫生—麻醉学]