智能自控静脉镇痛泵用于腰椎后路融合术后患者镇痛效果研究  

Analgesic effect of smart-PCIA on patients after posterior lumbar fusion

作　　者：梁赟 佘濛 高子军 董补怀[2] LIANG Yun;SHE Meng;GAO Zijun;DONG Buhuai(Xi’an Medical University,Xi’an 710068,China)

机构地区：[1]西安医学院,陕西西安710068 [2]西安交通大学附属红会医院,陕西西安710054

出　　处：《陕西医学杂志》2022年第2期180-185,共6页Shaanxi Medical Journal

基　　金：西安市科技计划项目(20YXYJ0004(6))。

摘　　要：目的:评价智能自控静脉镇痛(Smart-PCIA)泵应用于腰椎后路融合术后患者的镇痛及镇静效果。方法:选择行腰椎后路融合手术的患者120例,手术结束后使用病人自控静脉镇痛(PCIA)泵术后镇痛,采用随机数字表将患者分为两组,常规组(C组,n=60)使用恒速PCIA泵,智能组(S组,n=60)使用Smart-PCIA泵。比较两组术后48 h的镇痛和镇静效果及对患者术后恢复的影响。结果:S组术后12 h内镇痛药消耗量和PCIA有效按压次数高于C组(P<0.05),补救镇痛率低于C组(P<0.05)。而在术后12~48 h时段,S组镇痛药消耗量低于C组(P<0.05),有效按压次数高于C组(P<0.05)。S组术后48 h泵内镇痛药总用量低于C组(P<0.05)。两组术后1、12、24、48 h的疼痛评分和镇静评分差异均无统计学意义(P>0.05),S组在术后24~48 h时段恶心呕吐发生率低于C组(P<0.05),而患者满意度高于C组(P<0.05)。结论:Smart-PCIA泵用于腰椎后路融合术时,能在有效降低镇痛药消耗量的基础上提供确切的镇痛效果,并减少镇痛药的不良反应发生率且患者满意度更高。Objective:To evaluate the analgesic and sedative effects of smart-patient controlled intravenous analgesia(smart-PCIA)pump in patients after posterior lumbar fusion.Methods:120 patients undergoing posterior lumbar fusion were selected.After the operation,they were treated with patient controlled intravenous analgesia(PCIA)pump for postoperative analgesia.The patients were randomly divided into two groups.The conventional group(group C,60 cases)used constant speed PCIA pump,and the smart group(group S,60 cases)used smart-PCIA pump.The analgesic and sedative effects 48 hours after operation and their effects on postoperative recovery were compared between the two groups.Results:The anesthetic dosage and effective pressing times of PCIA within 12 hours postoperatively in group S were higher than those in group C,and the rescue analgesia rate was lower than that in group C(all P<0.05).At 12 to 48 hours after operation,the anesthetic dosage in group S was lower than that in group C(P<0.05),and the effective pressing times of PCIA was higher than that in group C(all P<0.05).The total dosage of anesthetic drugs in group S 48 hours after operation was lower than that in group C(P<0.05).There was no significant difference in pain score and sedation score between the two groups at 1,12,24 and 48 hours after operation(P>0.05).The incidence of nausea and vomiting in group S was lower than that in group C,and the patient satisfaction was higher than that in group C(all P<0.05).Conclusion:Smart-PCIA pump can effectively reduce the consumption of narcotic drugs,provide accurate analgesic effect,reduce the incidence of adverse reactions of narcotic drugs,and have higher patient satisfaction.

关 键 词：智能自控静脉镇痛 舒芬太尼 右美托咪定 腰椎后路融合术 不良反应 满意度 

分 类 号：R614.2[医药卫生—麻醉学]