右美托咪定联合舒芬太尼用于老年高血压患者人工关节置换术后镇痛分析  

Analysis on analgesic effects of dexmedetomidine combined with sufentanil in elderly patients with hypertension after artificial joint replacement

作　　者：谢爱军[1] 郭金华[1] 马万福 XIE Aijun;GUO Jinhua;MA Wanfu(Department of Anesthesiology,Sanming Second Hospital,Fujian,Sanming 366000,China)

机构地区：[1]福建省三明市第二医院麻醉科

出　　处：《中国医药科学》2019年第20期90-94,共5页China Medicine And Pharmacy

摘　　要：目的分析右美托咪定联合舒芬太尼用于老年高血压患者人工关节置换术后镇痛效果。方法选取于2017年12月~2018年1月在我院接受人工关节置换术治疗的78例老年高血压患者为研究对象进行回顾性分析,根据患者用药方式的不同,将其分为对照组和观察组,每组39例。其中对照组患者给予常规药物(舒芬太尼)进行麻醉,而观察组在此基础上联合右美托咪定进行麻醉。观察两组围手术期的血流动力学变化情况以及术后疼痛、镇静评分;此外,分析舒芬太尼的用量及其用药期间的不良反应。结果两组患者术前、术中和术后的血氧饱和度以及心率比较,组间差异均无统计学意义(P>0.05);且两组镇静评分在各个时间段(1h、2h、12h、24h)对比差异无统计学意义(P>0.05);但观察组术后1h以及2h内的疼痛评分较对照组低(P<0.05);而在术后12h和24h内两组术后疼痛评分对比差异无统计学意义(P>0.05);同时观察组24h内舒芬太尼药物使用剂量低于对照组(P<0.05),在此期间两组患者未出现呼吸抑制等不良反应。结论对老年高血压患者采用右美托咪定联合舒芬太尼更能稳定患者人工关节置换术后的镇痛效果,且有助于减少舒芬太尼的使用量,从而提高用药的安全性。Objective To analyze analgesic effects of dexmedetomidine combined with sufentanil in elderly patients with hypertension after artificial joint replacement.Methods 78 elderlypatients who underwent artificial joint replacement in our hospital from December 2017 to January 2018 were selected as research objects and retrospectively analyzed.The patients were divided into the control group and the observation group according to their different medication methods,with 39 cases in each group.Patients in the control group were anesthetized with the conventional drug(sufentanil)while patients in the observation group were anesthetized with dexmedetomidine.Perioperative hemodynamic changes and postoperative pain and sedation scores were observed in 2 groups.In addition,the amount of sufentanil and the adverse reactions during the administration should be analyzed.Results There were statistically significant difference in blood oxygen saturation and heart rate of the two groups before operation,during operation and after operation(P<0.05).There was no statistically significant difference in sedation scores between the two groups at different time periods(1h,2h,12h,24h)(P>0.05).However,the pain scores of the observation group were lower than those of the control group at 1h and 2h after operation(P<0.05).There was no statisticallysignificant difference in postoperative pain scores between the two groups at 12h and 24h after surgery(P>0.05).At the same time,the dose of sufentanil was lower than that of the control group within 24 hours(P<0.05).During this period,there were no adverse reactions such as respiratory depression in patientsbetween the two groups.Conclusion Dexmedetomidine combined with sufentanil in elderly patients with hypertension can stabilize the analgesic effect after artificial joint replacement and help to reduce the use of sufentanil,thereby improving the safety of medication.

关 键 词：右美托咪定 舒芬太尼 老年高血压 人工关节置换术 

分 类 号：R614[医药卫生—麻醉学]