老年患者腰椎术后应用右美托咪定对舒芬太尼术后镇痛的影响

Effect of Dexmedetomidine on postoperative analgesia of Sufentanil in elderly patients after lumbar spine surgery

摘要:

目的观察老年患者腰椎术后应用右美托咪定对舒芬太尼术后镇痛的影响。方法选取2015年1月-2016 年1 月在该院老年腰椎手术患者90 例，随机分为观察组和对照组，每组45 例，观察组患者在术后应用（舒芬太尼+ 右美托咪定）镇痛，对照组患者在术后应用舒芬太尼镇痛，观察两组患者的镇痛效果和不良反应。结果①观察组在术后多个时间点的视觉模拟评分（VAS）与Ramesay 镇静评分均优于对照组，组间差异有统计学意义（p <0.05）；②观察组在各个时间点的血压、心率及血氧变化均比对照组稳定（p <0.05）；③观察组不良反应发生率为6.6%，对照组不良反应发生率为37.7%，组间差异有统计学意义（p <0.05）。结论舒芬太尼合用右美托咪定可有效治疗老年患者腰椎术后疼痛，不良反应发生率低。

Abstract:

Objective To observe the effect of Dexmedetomidine on the postoperative analgesic efficacy of Sufentanil in elderly patients after lumbar spine surgery. Methods Ninety elderly patients who underwent lumbar spine surgery between January 2015 and January 2016 in Xiangya Hospital were randomly divided into two groups: observation group ( n= 45) and control group ( n= 45). In terms of postoperative analgesia, the patients in the observation group received Sufentanil combined with Dexmedetomidine; only Sufentanil was utilized in the control group. The efficiency of analgesia and post-anesthesia complications in the two groups were observed. Results VAS score and Ramesay score in the observation group were dramatically lower than those in control group (p < 0.05). Blood pressure, heart rate and oxygen saturation of the patients in the observation group were more stable than those of the patients in the control group (p < 0.05). The incidences of complications were significantly lower in the observation group when compared to those in the control group (6.6% vs 37.7% ,p < 0.05). Conclusions Combination of Sufentanil with Dexmedetomidine is synergistically better in treatment of postoperative pain for patients who undergo lumbar spine surgery with low incidences of adverse reactions in comparison with Sufentanil only.