低剂量右美托咪定鼻内给药改善硬膜外穿刺过程中疼痛的疗效

The Effect of Low Dose dexmedetomidine in Improving the Pain of Epidural Puncture

目的:观察在对下肢骨折患者硬膜外穿刺过程中进行低剂量右美托咪定鼻内给药对于患者疼痛症状改善的作用。方法:选取厦门市同安区中医医院2022年3月至2023年3月进行连续硬膜外麻醉的76例下肢骨折患者,采用随机数字表划分对照组(常规方案进行连续硬膜外穿刺麻醉)和观察组(常规连续硬膜外穿刺麻醉+低剂量右美托咪定鼻内给药麻醉),每组38例,评估两组患者在硬膜外穿刺过程中疼痛程度。结果:观察组患者在穿刺过程中、穿刺后疼痛程度低于对照组,镇静评分高于对照组,差异具有统计学意义(P<0.05);观察组患者在穿刺后、术中、术后的心率、收缩压均低于对照组,差异具有统计学意义(P<0.05);观察组患者术后不良反应总发生率低于对照组,差异具有统计学意义(P<0.05)。结论:在对下肢骨折患者开展连续硬膜外麻醉过程中采用低剂量右美托咪定鼻内给药,可以有效降低患者在穿刺过程中疼痛感,并增加患者在麻醉过程中镇静程度,减少硬膜外穿刺过程中的紧张情绪,减少手术过程中患者血流波动,有助于患者术后恢复。

Objective To observe the effect of intranasal administration of low dose dexmedetomidine during epidural puncture in patients with lower extremity fracture on improvement of pain symptoms.Methods A total of 76 patients with lower extremity fracture who underwent continuous epidural anesthesia in the Xiamen Tongan District Hospital of Traditional Chinese Medicine from March 2022 to March 2023 were selected and randomly divided into a control group(continuous epidural puncture anesthesia with routine regimen)and an observation group(routine continuous epidural puncture anesthesia+low dose dexmedetomidine intranasal anesthesia)with 38 cases in each group.The degree of pain during epidural puncture was evaluated in both groups.Results The pain degree during and after puncture in the observation group was lower than those in the control group,and the sedation score was higher that in the control group,the differences were statistically significant(P<0.05).The heart rate and systolic blood pressure of the observation group after puncture,during operation and after operation were lower than those of the control group,and the differences were statistically significant(P<0.05).The total incidence of postoperative adverse reactions in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Intranasal administration of low dose dexmedetomidine during continuous epidural anesthesia for patients with lower extremity fractures can effectively reduce the pain of patients during puncture,increase the degree of sedation of patients during anesthesia,reduce the tension during epidural puncture,reduce the fluctuation of blood flow during surgery,and contribute to postoperative recovery of patients.