脊柱手术后不同镇痛配方的临床疗效研究

目的探讨脊柱手术后不同自控镇痛(PCA)配方的临床疗效。方法将纳入择期行脊柱手术的ASAⅠ～Ⅲ级患者120例,随机分为两组,每组各60例。术中均采用硬膜外麻醉或腰-硬联合麻醉,术毕前接自控镇痛泵。观察组为氯诺昔康联合舒芬太尼组,氯诺昔康40mg+舒芬太尼100ug+0.9%Nacl溶液配成100ml;对照组为舒芬太尼组,舒芬太尼100ug+0.9%Nacl溶液配成100ml。两组溶液均加入一次性止痛泵内,设定基础速度为2ml/h,自控锁定0.5ml/15min。采用VAS评分法评定术后4、8、12、24、48h疼痛程度,观察不良反应发生情况,记录患者满意度。结果两组患者均取得满意镇痛效果,氯诺昔康联合舒芬太尼组镇痛效果更佳,两组比较差异有统计学意义(P<0.05),不良反应率无明显差异,患者满意度较好。结论氯诺昔康联合舒芬太尼用于脊柱手术后取得较好的镇痛效果且不良反应少。

Objective After spinal surgery patients explore different controlled analgesia（PCA）formula of clinical curative effect.Methods Included in elective spinal surgery were ASA Ⅰ～Ⅲ grade 120 cases were randomly divided into two groups of 60 cases.Intraoperative use of epidural anesthesia or spinal-epidural anesthesia,patients received PCA pump before completion.Observation group,lornoxicam co-sufentanil group,lornoxicam 40mg＋sufentanil 100ug＋0.9%Nacl solution dubbed 100ml;control group,sufentanil,sufentanil 100ug＋0.9%Nacl solution dubbed 100ml.Groups by adding a one-time solution,pain pump,set the base rate of 2ml /h,controlled lock 0.5ml/15min.Assessed by VAS score 4,8,12,24,48 hours after pain,side effects were observed,recorded patient satisfaction.Results All patients achieved satisfactory analgesia with lornoxicam co for better analgesic effect of sufentanil group,the difference was statistically significant（P0.05）,no significant difference in rates of adverse reactions,patient satisfaction Better.Conclusion Lornoxicam co-sufentanil for spinal surgery patients can get a better analgesic effect and adverse reactions.