右美托咪啶联合喉上神经阻滞对改良腭咽成形术患者疼痛评分、生活质量及安全性的影响  

Effect of dexmedetomidine combined with superior laryngeal nerve block on pain scores,quality of life,and safety in patients underwent modified palatopharyngoplasty

作　　者：唐晓怡 赵倩[1] TANG Xiaoyi;ZHAO Qian(Department of Anesthesiology,The Fourth Hospital of Changsha,Changsha 410006,Hunan,China)

机构地区：[1]长沙市第四医院麻醉科,湖南长沙410006

出　　处：《贵州医科大学学报》2022年第8期988-992,共5页Journal of Guizhou Medical University

摘　　要：目的研究右美托咪啶联合喉上神经阻滞对改良腭咽成形术患者疼痛评分、生活质量的影响。方法将68例改良腭咽成形术患者均分为右美托咪啶组(D组)和喉上神经阻滞联合右美托嘧啶组(SD组),于麻醉前(T_(0))、给药后10 min(T_(1))、给药后30 min(T_(2))、给药后60 min(T_(3))、手术结束(T_(4))时使用VAS评分对患者进行疼痛程度评价;同时采用Ramsay镇静评分、BCS评分评价镇静效果及舒适度,并观察手术期间两组患者继发效应发生情况;术后采用健康调查简表(SF-36)调查患者生活质量。结果在T_(0)时点,D组OSAHS患者和SD组患者VAS评分、Ramsay镇静评分及BCS评分比较,差异无统计学意义(P>0.05);T_(1)~T_(4)时段,SD组OSAHS患者VAS评分、Ramsay镇静评分显著低于D组,差异有统计学意义(P<0.05);T_(3)~T_(4)时段SD组OSAHS患者BCS评分低于D组,差异有统计学意义(P<0.05);术后SD组OSAHS患者SF-36评分各项评分高于D组(P<0.05),且SD组出现继发效应3例(8.82%)显著低于D组的12例(35.29%),差异有统计学意义(χ^(2)=5.400,P=0.021)。结论右美托咪啶联合喉上神经阻滞能有效地提高改良腭咽成形术患者的疼痛评分及生活质量。Objective To investigate the effect of dexmedetomidine combined with superior laryngeal nerve block on pain score and quality of life in patients underwent modified palatopharyngoplasty.Methods A total of 68 patients underwent modified palatopharyngoplasty were divided into dexmedetomidine group(D group)and superior laryngeal nerve block combined with dexmedetomidine group(SD group).Visual analogue scale(VAS)was used to evaluate the pain degree of the patients before anesthesia(T_(0)),at 10 min(T_(1)),30 min(T_(2)),and 60 min(T_(3))after drug administration and at the end of surgery(T_(4)).Ramsay sedation scale and Bruggrmann comfort scale(BCS)were applied to evaluate the sedation and comfort.The secondary effects of two groups were observed during the surgery,and the quality of life of the patients was investigated by the Short Form health Survey(SF-36)after surgery.Results There were no significant differences in VAS score,Ramsay sedation scale and BCS between D and SD groups at T_(0) time point(P>0.05).VAS and Ramsay sedation scale were significantly lower in SD group than those in D group during T_(1)-T_(4)(P<0.05).BCS in SD group was lower than that in D group during T_(3)-T_(4)(P<0.05).Postoperative SF-36 scores in SD group were higher than those in D group(P<0.05).The secondary effects were significantly lower in SD group(3/34,8.82%)than those in D group(12/34,35.29%;χ^(2)=5.400,P=0.021).Conclusion Dexmed etomidine combined with superior laryngeal nerve block can effectively reduce pain score and improve quality of life in patients underwent modified palatopharyngoplasty.

关 键 词：改良腭咽成形术 右美托咪啶 喉上神经阻滞 生活质量 镇痛 镇静 

分 类 号：R562.1[医药卫生—呼吸系统]