镇静评分是术后椎管内吗啡镇痛呼吸抑制的可靠指标

SEDATION SCALERELIABLE SIGN FOR RESPIRATORY DEPRESSION OF INTRASPINAL POSTOPERATIVE ANALGESIA

目的：了解Ｒａｍｓａｙ镇静评分在椎管内吗啡术后镇痛呼吸抑制诊断中的价值。方法：研究Ａ：从硬膜外麻醉下经腹腔子宫全部切除并行术后硬膜外吗啡镇痛的病人中，随机选择Ｒａｍｓａｙ评分Ⅱ～Ⅲ级病人２３例（组１），Ｒａｍｓａｙ评分Ｖ级病人１８例（组２）。研究Ｂ：在脊椎硬膜外联合麻醉下经腹腔子宫全部切除并行术后蛛网膜下腔吗啡镇痛病人中，随机选择Ｒａｍｓａｙ评分ⅡⅢ级病人２１例（组１），Ｒａｍｓａｙ评分Ｖ级病人１３例（组２）。组间比较相应镇静评分时所测呼吸频率、ＳｐＯ２、收缩压、心率的差异。结果：无论在研究Ａ或研究Ｂ，Ｒａｍｓａｙ评分Ⅱ～Ⅲ级的病人ＳｐＯ２显著高于评分Ⅴ级的病人（Ｐ＜０．０５），其余指标无显著性差异（Ｐ＞０．０５）。结论：Ｒａｍｓａｙ镇静评分较好地反映了ＳｐＯ２变化，是监视椎管内吗啡镇痛呼吸抑制的可靠指标。

Objective: The usage of Ramsay sedation scale for the respiratory depression of postoperative intraspinal morphine analgesia. Methods. Study A: Patients under epidural anaesthesisa and morphine analgesia were recruited randomly, inculuding 23 cases of Ramsay - grade and 18 cases of Ramsay V grade. Study B: Patients under combined spinalepidural anaesthesia and subarachnoid morphine analgesia were recruited randomly, with 21 cases of Ramsay - grade and 13 cases of Ramsay V grade. The respiratory rate, oxygen saturation (SpO2), systolic blood pressure, heart rate and visual analog scale (VAS) were measured for comparison between the groups (Ramsay / versus ). Results: In both studies, the SpO2 in Ramsay / grade was significantly higher than that in Ramsay group (P<0.05). The other indexes were not significantly different between the 2 gruoup (P>0.05). Conclusion: Ramsay sedation scale has a good correlation with SpO2, therefore, can be used as an reliable index for monitoring the respiratory depression during postoperative intraspinal morphine analgesia.