右美托咪定联合舒芬太尼在全髋关节置换术后静脉自控镇痛中的应用效果  

Application effects of Dexmedetomidine combined with Sufentanil in patient-controlled intravenous analgesia after total hip arthroplasty

作　　者：娄翠丽 芦舒 LOU Cuili;LU Shu(Department of Anesthesiology of 15th People’s Hospital of Zhengzhou,Zhengzhou 450041 Henan,China;Pharmacy and Equipment Department of Nanyang Orthopaedic Hospital,Nanyang 473000 Henan,China)

机构地区：[1]郑州市第十五人民医院麻醉科,河南郑州450041 [2]南阳市骨科医院药械科,河南南阳473000

出　　处：《中国民康医学》2023年第4期67-69,共3页Medical Journal of Chinese People’s Health

摘　　要：目的:观察右美托咪定联合舒芬太尼在全髋关节置换术(THA)后静脉自控镇痛(PCIA)中的应用效果。方法:选取2020年7月至2021年10月于郑州市第十五人民医院行THA治疗的88例患者进行前瞻性研究,按随机数字表法将其分为对照组和观察组各44例。两组术后镇痛方法均为PCIA,对照组采用舒芬太尼镇痛,观察组采用右美托咪定联合舒芬太尼镇痛,两组均添加盐酸昂丹司琼防止呕吐。比较两组镇痛效果[视觉模拟评分法(VAS)评分]、镇静效果(Ramsay镇静评分)、舒适度(BCS)评分、术后24 h舒芬太尼用量、PCIA总按压次数及不良反应发生率。结果:术后4、24 h,观察组VAS评分均低于对照组,Ramsay和BCS评分均高于对照组,差异有统计学意义(P<0.05);观察组舒芬太尼用量和PCIA总按压次数均少于对照组,差异有统计学意义(P<0.05);观察组不良反应发生率为11.36%(5/44),低于对照组的45.45%(20/44),差异有统计学意义(P<0.05)。结论:右美托咪定联合舒芬太尼应用于THA术后PCIA可提高镇痛效果,降低不良反应发生率,减少舒芬太尼用量和PCIA总按压次数,提高镇静评分和舒适度评分,效果优于单用舒芬太尼。Objective:To observe application effects of Dexmedetomidine combined with Sufentanil in patient-controlled intravenous analgesia(PCIA)after total hip arthroplasty(THA).Methods:A prospective study was conducted on 88 patients who underwent THA in The 15th People’s Hospital of Zhengzhou from July 2020 to October 2021.They were divided into control group and observation group according to the random number table method,44cases in each.Both groups were treated with PCIA.The control group was treated with Sufentanil,while the observation group was treated with Dexmedetomidine combined with Sufentanil.The analgesic effects,the sedative effects,the comfort degree,the Sufentanil dosage,the total pressing times of PCIA,and the incidence of adverse reactions were compared between the two groups.Results:4 and 24 h after the surgery,the VAS scores of the observation group were lower than those of the control group,the Ramsay scores and the BCS scores were higher than those of the control group,and the differences were statistically significant(P<0.05).The dosage of Sufentanil and the total pressing times of PCIA in the observation group were less than those in the control group,and the differences were statistically significant(P<0.05).Further,the observation group had lower incidence of adverse reactions of 11.36%(5/44)than 45.45%(20/44)in the control group,and the difference was statistically significant(P<0.05).Conclusions:The application of Dexmedetomidine combined with Sufentanil in PCIA after THA can reduce the VAS score and the incidence of adverse reactions,reduce the dosage of Sufentanil and the total pressing times of PCIA,and improve the sedation score and the comfort score.Moreover,it is superior to Sufentanil.

关 键 词：全髋关节置换术 右美托咪定 舒芬太尼 静脉自控镇痛 镇痛 镇静 

分 类 号：R614[医药卫生—麻醉学]