地佐辛超前镇痛用于鼻骨骨折整复术的效果观察  

Effect of dezocine preemptive analgesia in the reconstruction of nasal bone fracture

作　　者：周颖 危高生 刘荣 刘龙英 李育广 Zhou Ying;Wei Gaosheng;Liu Rong;Liu Longying;Li Yuguang(Department of Stomatology, the 908th Hospital of Chinese People's Liberation Army Joint Logistic Support Force, Yingtan, Jiangxi 335000, China;Department of Ophthalmology and Otorhinolaryngology, Yingtan People's Hospital, Yingtan, Jiangxi 335000, China;Department of Anesthesiology, the 908th Hospital of Chinese People's Liberation Army Joint Logistic Support Force, Yingtan, Jiangxi 335000, China)

机构地区：[1]解放军联勤保障部队第九〇八医院口腔科,江西省鹰潭335000 [2]鹰潭市人民医院五官科,江西省335000 [3]解放军联勤保障部队第九〇八医院麻醉科,江西省鹰潭335000

出　　处：《中国基层医药》2019年第15期1814-1817,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨地佐辛超前镇痛在鼻骨骨折整复术中的安全性及有效性。方法选择解放军联勤保障部队第九〇八医院2016年9月至2018年5月收治的鼻骨骨折患者63例为研究对象,采用随机数字表法分为地佐辛超前镇痛组(n=32)、对照组(n=31),地佐辛超前镇痛组术前肌内注射地佐辛,对照组肌内注射0.9%氯化钠注射液。观察两组各时点平均动脉压(MAP)、心率(HR)、脉搏血氧饱和度(SpO2)的变化,比较两组术中及术后2 h视觉模拟量表评分(VAS评分)。结果注射药物前10 min、注射药物后10 min,两组MAP差异均无统计学意义(均P>0.05);手术时、手术后20 min,对照组MAP分别为(110.1±16.38)mmHg、(105.28±14.81)mmHg,地佐辛超前镇痛组分别为(102.35±14.25)mmHg、(101.25±13.12)mmHg,两组差异均有统计学意义(t=2.259、2.153,均P<0.05)。注射药物前10 min、注射药物后10 min,两组HR差异均无统计学意义(均P>0.05);手术时、手术后20 min,对照组HR分别为(90.81±19.52)次/min、(77.25±18.25)次/min,均明显快于地佐辛超前镇痛组的(85.16±17.25)次/min、(71.36±16.15)次/min,差异均有统计学意义(t=2.074、2.047,均P<0.05)。两组各时点SpO2差异均无统计学意义(均P>0.05)。地佐辛超前镇痛组术中Ramsay镇静评分为(4.3±0.6)分,优于对照组的(2.1±0.4)分,差异有统计学意义(t=17.008,P<0.05)。地佐辛超前镇痛组术中、术后2 h的VAS评分分别为(2.3±0.5)分、(1.5±0.8)分,均优于对照组的(5.5±0.7)分、(2.1±0.6)分(t=20.572、3.277,均P<0.05)。结论地佐辛超前镇痛可安全有效地应用于鼻骨骨折整复术,术中血流动力学平稳,镇痛效果确切。Objective To explore the safety and efficacy of dezocine preemptive analgesia in the reconstruction of nasal bone fracture. Methods From September 2016 to May 2018, 63 patients with simple nasal bone fracture admitted to the 908th Hospital of PLA Joint Logistics Support Force were selected in the study.The patients were divided into two groups by random number table method: dezocine group(n=32) and control group(n=31). The dezocine group was injected with dezocine before surgery, while the control group was injected with 0.9% sodium chloride solution.The differences of MAP, HR, SpO2 at different time points between the two groups were observed.And the difference of VAS/RSS during operation and 2 hours after surgery were also observed. Results There were no statistically significant differences in MAP, HR and SpO2 between the two groups at different time points(10 min before and 10 min after intramuscular injection)(all P>0.05). During operation and 20 min after operation, the MAP values of the control group were (110.1±16.38)mmHg and (105.28±14.81)mmHg, respectively, which were higher than those of the dezocine group [(102.35±14.25)mmHg and (101.25±13.12)mmHg)], the differences were statistically significant(t=2.259, 2.153, all P<0.05). There were no statistically significant difference in HR between the two groups at 10 min before and 10 min after intramuscular injection(all P>0.05). The HR in the control group during operation and at 20min after operation were (90.81±19.52)times/min,(77.25±18.25)times/min, respectively, which were faster than those in the dezocine group [(85.16±17.25)times/min,(71.36±16.15)times/min], the differences were statistically significant(t=2.074, 2.047, all P<0.05). There were no statistically significant differences in SpO2 between the two groups at different time points(all P>0.05). In the surgery, the RSS score of dezocine group[(4.3±0.6)points] was better than that in control group[(2.1±0.4)points], the difference was statistically significant(t=17.008, P<0.05). The VAS

关 键 词：鼻骨 骨折 骨折整复术 麻醉前用药 麻醉和镇痛 地佐辛 血流动力学 对比研究 

分 类 号：R614[医药卫生—麻醉学]