不同剂量瑞芬太尼复合七氟烷用于脊柱手术患者的临床研究  

Clinical trial of different doses of remifentanil combined with sevoflurane in the treatment of patients undergoing spinal surgery

作　　者：谭海涛[1] 陈涛 黎坚[1] 林友才[1] TAN Hai-tao;CHEN Tao;LI Jian;LIN You-cai(Spinal Surgery,The First Affiliated Hospital of Hainan Medical College,Haikou 570102,Hainan Province,China)

机构地区：[1]海南医学院第一附属医院脊柱外科,海南海口570102

出　　处：《中国临床药理学杂志》2024年第20期2958-2962,共5页The Chinese Journal of Clinical Pharmacology

摘　　要：目的 观察不同剂量瑞芬太尼复合七氟烷用于脊柱手术患者的临床疗效及安全性。方法 将脊柱手术患者分为低剂量组、中剂量组及高剂量组。低、中和高剂量组分别给予静脉泵注0.2、0.4和0.6μg·kg^(-1)·min^(-1)注射用盐酸瑞芬太尼。比较3组患者的疼痛情况[视觉模拟评分(VAS)]、镇痛药物使用情况、苏醒质量、不同时刻[术前(T_(0))、插管即刻(T_(1))、静脉泵注瑞芬太尼5 min(T_(2))、10 min(T_(3))、15 min(T_(4))]血流动力学指标,并进行安全性评价。结果 低、中和高剂量组分别入组49、56和51例患者。低剂量组患者术后6、12和24 h VAS评分分别为(2.48±0.51)、(2.73±0.63)和(2.61±0.54)分,中剂量组VAS评分分别为(2.36±0.54)、(2.65±0.59)和(2.51±0.50)分,高剂量组VAS评分分别为(2.29±0.53)、(2.53±0.57)和(2.44±0.52)分,组间比较,在统计学上差异均无统计学意义(均P>0.05)。低、中和高剂量组自控镇痛泵按压次数分别为(3.27±0.96)、(3.02±0.90)和(2.89±0.71)次,补救镇痛例数分别为2例(4.08%)、2例(3.57%)和0例(0.00%),在统计学上差异均无统计学意义(均P>0.05)。低、中和高剂量组苏醒时间分别为(7.05±1.65)、(8.24±2.17)和(9.03±2.48) min,意识恢复时间分别为(11.26±2.73)、(13.85±2.94)和(15.57±3.17) min,气管拔管时间分别为(16.34±3.05)、(18.72±3.29)和(20.34±3.58) min,组间比较,在统计学上差异均有统计学意义(均P<0.05)。3组患者的T_(0)、T_(1)、T_(2)、T_(3)、T_(4)时间点血氧饱和度(SpO_(2))、平均动脉压、心率比较,组间比较,在统计学上差异均无统计学意义(均P>0.05)。3组患者发生药物不良反应主要有低血压、恶心呕吐、心动过缓等,高、中、低剂量组总药物不良反应发生率分别为11.76%(6例/51例)、7.14%(4例/56例)和8.16%(4例/49例),组间比较,在统计学上差异均无统计学意义(均P>0.05)。结论 脊柱手术患者采用0.2μg·kg^(-1)·min^(-1)瑞芬太尼复合七氟�Objective To observe the efficacy and safety of different doses of remifentanil combined with sevoflurane in patients undergoing spinal surgery.Methods Patients undergoing spinal surgery were divided into low dose group,medium dose group and high dose group.Low dose group,medium dose group and high dose group were given 0.2,0.4 and 0.6μg·kg^(-1)·min^(-1)remifentanil by intravenous pump,respectively.Pain status[visual analogue score(VAS)],analgesic drug use,quality of recovery,hemodynamic indexes at different times[before surgery(T_(0)),immediately after intubation(T_(1)),intravenous pump injection of remifentanil 5 min(T_(2)),10 min(T_(3)),15 min(T_(4))]of the 3 groups were compared;and safety was evaluated.Results The low,medium and high dose groups were enrolled in 49,56 and 51 patients,respectively;the VAS scores at 6,12 and 24 h after operation in the low dose group were(2.48±0.51),(2.73±0.63)and(2.61±0.54)points,respectively;the VAS scores in the medium dose group were(2.36±0.54),(2.65±0.59)and(2.51±0.50)points,respectively;the VAS scores in the high dose group were(2.29±0.53),(2.53±0.57)and(2.44±0.52)points,respectively.There was no statistically significant difference between the groups(all P>0.05).The number of patient-controlled analgesia pump compressions in the low,medium and high dose groups were(3.27±0.96),(3.02±0.90)and(2.89±0.71)times,respectively;the number of remedial analgesia cases was 2 cases(4.08%),2 cases(3.57%)and 0 cases(0.00%),respectively.There was no statistically significant difference(all P>0.05).The recovery time of low,medium and high dose groups were(7.05±1.65),(8.24±2.17)and(9.03±2.48)min,respectively;the recovery time of consciousness were(11.26±2.73),(13.85±2.94)and(15.57±3.17)min,respectively;the extubation time were(16.34±3.05),(18.72±3.29)and(20.34±3.58)min,respectively.The differences were statistically significant(all P<0.05).There was no significant difference in blood oxygen saturation(SPO_2),mean arterial pressure and heart rate at time points of

关 键 词：瑞芬太尼 七氟烷 脊柱手术 镇痛 苏醒质量 血流动力学 

分 类 号：R971[医药卫生—药品]