凯芬联合右美托咪定治疗老年患者全麻膝关节置换术后苏醒期疼痛与躁动的影响

Therapeutic effect of Kefen combined with dexmedetomidine on pain and agitation during recovery from general anesthesia and knee joint replacement in elderly patients

目的:探讨凯芬联合右美托咪定治疗老年患者全麻膝关节置换术后苏醒期的疼痛与躁动的影响。方法:选取2018年8月~2020年8月本院收治的接受全麻膝关节置换术治疗的老年患者60例为研究对象,随机数字表法分成2组,对照组患者(30例)手术结束前30min给予静脉注射氟比洛芬酯50mg,观察组患者(30例)手术结束前30min给予静脉注射右美托咪定0.25μg/k和氟比洛芬酯50mg,观察比较两组患者苏醒期一般手术情况、VAS评分及Riker镇静躁动评分、Ramsay镇静评分、躁动发生率。结果:两组患者麻醉时间及手术时间比较,差异无统计学意义;观察组患者苏醒时间及拔管时间均短于对照组患者,差异存在显著性;两组患者术后2~4hVAS评分均显著增高,8h后VAS评分呈下降趋势;经重复测量的方差分析发现,两组患者术后2hVAS评分差异无统计学意义;观察组术后4h、8h及24hVAS评分均明显低于对照组,观察组患者苏醒期Riker评分及躁动发生率明显低于对照组、Ramsay评分高于对照组患者。结论:氟比洛芬酯(凯芬)联合右美托咪定可有效降低老年患者全麻膝关节置换术后苏醒期躁动,缓解疼痛程度,疗效确切,值得临床推广。

Objective To investigate the effects of Kefen combined with dexmedetomidine on pain and agitation during recovery from general anesthesia and knee joint replacement in elderly patients.Methods A total of 60 elderly patients who underwent general anesthesia and knee arthroplasty admitted to our hospital from August 2018 to August 2020 were enrolled.The random number table is divided into two groups,and the control group(30 patients)underwent surgery.Intravenous dexmedetomidine 0.25μg/kg was given 30 min before the end,and the patients in the observation group(30 patients)were given intravenous dexmedetomidine 0.25μg/k and flurbiprofen 50 mg 30 min before the end of surgery.The general surgery,VAS score,Riker sedation and agitation score,Ramsay sedation score,and incidence of agitation in the recovery group.Results There was no significant difference in anesthesia time and operation time between the two groups.The recovery time and extubation time of the observation group were shorter than those of the control group,and the difference was significant.The VAS scores of the two groups were significantly increased after 2-4 hours,and the VAS scores decreased after 8 hours.The repeated measures of variance analysis showed that there was no significant difference in the 2h VAS score between the two groups.The VAS scores of the 4h,8h and 24h were significantly lower than those of the control group.The incidence of Riker score and agitation in the observation group was significantly lower than that in the control group,and the Ramsay score was higher than that in the control group.Conclusion Flurbiprofen axetil(Kefing)combined with dexmedetomidine can effectively reduce the agitation during the recovery period after general anesthesia and knee joint replacement in elderly patients,and relieve the pain degree.The curative effect is definite and worthy of clinical promotion.