右美托咪定联合舒芬太尼用于老年脊柱手术术后镇痛效果观察

Analgesic effects of dexmedetomidine combined with sufentanil in elderly patients undergoing spine surgeries

目的探讨右美托咪定联合舒芬太尼用于老年脊柱手术患者术后镇痛的临床疗效。方法选取在我院行全麻下脊柱手术的老年患者126例,随机分为3组给予术后镇痛:A组(舒芬太尼1.0μg/kg)、B组(舒芬太尼1.5μg/kg)、C组(舒芬太尼1.0μg/kg+右美托咪定2.0μg/kg),对三组患者术后镇痛、镇静效果及不良反应进行比较。结果A组患者在1～6 h、6～12 h、12～24 h、24～48 h按压镇痛泵次数明显高于B、C组(P<0.05);B、C组患者术后2、4、8、12、24、48 h静息痛、运动痛及Ramsay镇静评分优于A组(P<0.05或P<0.01);C组术后恶心呕吐例数低于A、B组(P<0.01),C组患者镇痛期间呼吸抑制(遗忘)例数低于B组(P<0.05)。结论右美托咪定联合舒芬太尼用于老年脊柱手术患者术后镇痛、镇静效果良好,显著减少阿片类药物的用量,不良反应少,值得推广。

Objective To explore the analgesic effects of dexmedetomidine combined with sufentanil in elderly patients undergoing spine surgery.Methods 126 elderly patients undergoing spine surgeries in our hospital were divided into 3 groups according to the postoperative analgesic manners：group A（sufentanil 1.0 μg/kg）,group B（sufentanil 1.5 μg/kg）and group C（sufentanil 1.0 μg/kg ＋ dexmedetomidine 2.0 μg/kg）.The analgesic,sedative and adverse effects in the 3 groups were compared.Results The frequency of pressing analgesia pump in group A was obviously higher than that in group B and group C at 1~6 h,6~12 h,12~24 h and 24~48 h;the scores of resting pain,movement pain and Ramsay calm rating of group B and group C were better than those of group A（P0.05 or P0.01）at postoperative 2,4,8,12,24,48 h;the incidence of postoperative nausea and vomiting in group C was significantly lower than that in group A and group B（P0.01）,and the incidence of respiratory depression of group C was significantly lower than that of group B（P0.05）.Conclusion Dexmedetomidine combined with sufentanil for elderly patients undergoing spine surgeries has good postoperative analgesic and calm effects with less adverse effects,it can significantly reduce the dosage of opioids,and it is worthy of popularizing.