舒芬太尼复合右美托咪啶用于腰椎术后患者镇痛的观察

Clinical observation of Sufentanil and dexmedetomidine used in analgesia after lumbar spine surgery

目的观察舒芬太尼复合右美托咪啶用于腰椎术后患者镇痛的临床效果。方法选择行腰椎手术患者60例,ASAI-II级,随机分为2组。A组观察组给予舒芬太尼2μg/kg加阿扎司琼10mg加右美托咪啶2μg/kg,生理盐水稀释至100ml。B组对照组单纯用舒芬太尼2μg/kg加阿扎司琼10mg,生理盐水稀释至100ml。2组均于术毕即刻静脉连接自控镇痛泵,背景剂量2ml/h,冲击量1ml,锁定时间15min,记录术后4、8、12、24、48h的视觉模拟评分(VAS)、Ramesay镇静评分及不良反应发生率。结果 2组病人镇痛效果良好,A组患者术后4、8和12h的Ramesay镇静评分低于B组(P<0.05),其他时间段差异无统计学意义(P>0.05),恶心、呕吐、头晕、皮肤瘙痒等不良反应A组明显少于B组,有显著差异(P<0.05)。结论舒芬太尼复合右美托咪啶镇痛效果优于单纯舒芬太尼,且可降低不良反应的发生率。

Objective To observe and compare the efficacy and safety of Sufentanil and dexmeditomidine for analgesia of patient undergoing lumar spine surgery.Methods Sixty patients（ASA Ⅰ~Ⅱ） undergoing lumar spine surgery were randomly divided into two groups.A group were given Sufentanil 2μg/kg,azasetron 10mg and dexmedetomidine 2ug/kg（NS 100ml）.B group were given Sufentanil 2μg/kg and azasetron 10mg.Two group were linked with analgesia pump,continuously 2ml/h and one bonus with 1ml at least 15 minutes.The study record the VAS（Visual Analogue Score） and Ramesay evaluation in 48 hours and the happen of adverse effect.Results The analgesia effect of two groups were good.Ramesay score of A group was lower than B group at 4,8,12h after operation（P〉0.05）,there were no differences in other time.（P〈0.05）.Conclusions The analgesia effect of Sufentanil combined with dexmeditomidine was better than Sufentanil alone and it reduce the happeness of adverse effect.