纳布啡联合瑞马唑仑多模式超前镇痛在腰椎后路内固定融合术患者中的应用  

Application of nalbuphine combined with remazolam multi-mode preanalgesia in patients undergoing posterior lumbar internal fixation fusion

作　　者：黄文 蒋斌 郑舟婷 HUANGWen;JIANG Bin;ZHENG Zhouting(Department of Anesthesiology,Shangrao Municipal Hospital,Shangrao,Jiangxi,334000,China;Department of Anesthesiology,Yanshan People's Hospital,Shangrao,Jiangxi,334100,China)

机构地区：[1]上饶市立医院麻醉科,江西上饶334000 [2]上饶市铅山县人民医院麻醉科,江西上饶334100

出　　处：《当代医学》2024年第10期35-39,共5页Contemporary Medicine

基　　金：上饶市科技计划一般项目(2022CZDX46)。

摘　　要：目的探讨纳布啡联合瑞马唑仑多模式超前镇痛对腰椎后路内固定融合术患者苏醒期躁动、术后镇痛及睡眠质量的影响。方法选取2021年1月至2023年3月上饶市立医院收治的90例腰椎后路内固定融合术患者作为研究对象,采用随机数字表法分为对照组与实验组,每组45例。对照组采用常规镇痛治疗,实验组采用纳布啡联合瑞马唑仑多模式超前镇痛治疗。比较两组Ricker镇静-躁动评分表(SAS)、视觉模拟评分法(VAS)、匹茨堡睡眠指数量表(PSQI)评分、术后镇痛及不良反应发生情况。结果实验组苏醒期躁动总发生率低于对照组,差异有统计学意义(P<0.05)。术后6、12、24、48h,实验组VAS评分均低于对照组,差异有统计学意义(P<0.05)。术后第2、3天,实验组PSQI评分均低于对照组,差异有统计学意义(P<0.05)。实验组镇痛泵首次按压时间长于对照组,补救镇痛次数少于对照组,差异有统计学意义(P<0.05)。实验组不良反应发生率为2.22%,低于对照组的22.22%,差异有统计学意义(P<0.05)。结论纳布啡联合瑞马唑仑多模式超前镇痛对降低腰椎后路内固定融合术患者苏醒期躁动的发生、减轻患者疼痛、提升患者睡眠质量具有积极意义。Objective To investigate the effects of nalbuphine combined with remazolam multi-mode preanalgesia on waking agitation,postoperative analgesia and sleep quality in patients undergoing posterior lumbar internal fixation and fusion.Methods 90 patients with posterior lumbar fixation fusion treated in Shangrao Municipal Hospital from January 2021 to March 2023 were selected as the study subjects,and they were divided into the control group and the experimental group according to random number table method,with 45 cases in each group.The control group was treat-ed with conventional analgesia,and the experimental group was treated with nalbuphine combined with remazolam multi-mode preemptive analgesia.The scores of Ricker sedation-agitation scale(SAS),visual analogue scale(VAS),Pittsburgh sleep index scale(PSQI),postoperative analgesia and adverse reactions were compared between the two groups.Results The total incidence of emergence agitation in the experimental group was lower than that in the control group,and the difference was statistically significant(P<0.05).At 6,12,24,48 h after operation,the VAS scores in the experimental group were lower than those in the control group,and the differences were statistically significant(P<0.05).On the 2 nd and 3 rd day after operation,the PSQI scores in the experimental group were lower than those in the control group,and the differences were statistically significant(P<0.05).The first pressing time of analgesia pump in the experimental group was longer than that in the control group,and the number of remedial analgesia was less than that in the control group,the differences were statistically significant(P<0.05).The incidence of adverse reactions in the experimental group was 2.22%,which was lower than 22.22%in the control group,and the difference was statistically significant(P<0.05).Conclusion Nalbuphine combined with remazolam multi-mode preanalgesia has positive significance in reducing agitation,relieving pain and improving sleep quality in patients with posterior lumbar

关 键 词：纳布啡 瑞马唑仑 超前镇痛 腰椎后路内固定融合术 

分 类 号：R614[医药卫生—麻醉学]