右美托咪定复合羟考酮在肩关节粘连传统手法松解术中的应用效果

Application effect of dexmedetomidine combined with oxycodone in traditional lysis method of shoulder joint adhesions

目的 观察右美托咪定（Dex）复合羟考酮在肩关节粘连传统手法松解术中的应用效果.方法选择行肩关节粘连传统手法松解术的患者60例,ASAⅠ或Ⅱ级,采用随机数字表法分为对照组和观察组,每组30例.对照组采用Dex 1.0μg/kg＋芬太尼1μg/kg.观察组采用Dex 1.0μg/kg＋羟考酮0.10 mg/kg.比较两组疼痛视觉（VAS）评分,以及术后不良反应的发生情况.结果随着术后镇痛时间的延长,各组VAS评分均有所下降,观察组患者在术后1 h、4 h、8 h VAS评分[（3.00±0.54）分、（1.98±0.56）分、（1.55±0.36）分]均低于对照组[（3.91±0.33）分、（2.88±0.66）分、（2.26±0.77）分],差异均有统计学意义（t=3.42、4.11、2.43,均P〈0.05）.术后12 h时,两组VAS评分差异无统计学意义（P〉0.05）.对照组不良反应发生率呼吸抑制、心动过速、术中知晓分别为26.7％（8/30）、50.0％（15/30）、13.3％（4/30）,观察组分别为6.7％（2/30）、20.0％（6/30）、0.0（0/30）,两组差异均有统计学意义（χ2=4.320、5.934、5.333,均P〈0.05）.结论Dex复合羟考酮可以保证良好的镇静遗忘效果,且不良反应发生率低.

Objective To observe the effect of dexmedetomidine （ Dex ） combined with oxycodone in the traditional lysis method of shoulder joint adhesions .Methods Sixty patients with shoulder joint adhesions in ASA Ⅰor Ⅱby the traditional lysis method were selected ,and they were randomly divided into control group and observation group,30 cases in each group.The control group was administered with Dex1.0μg/kg ＋fentanyl 1μg/kg.The observation group was administered with Dex1.0μg/kg＋oxycodone 0.10mg/kg.The VAS scores and postoperative adverse reactions were compared .Results The VAS score of each group decreased with the prolong of postoperative analgesia time.The VAS scores in the observation group at postoperative 1h,4h,8h[（3.00 ±0.54）points,（1.98 ± 0.56）points,（1.55 ±0.36） points] were lower than those in the control group [（3.91 ±0.33） points,（2.88 ± 0.66）points,（2.26 ±0.77）points],the differences were statistically significant （t =3.42,4.11,2.43,all P 〈0.05）.There was no statistically significant difference in VAS score between the two groups at postoperative 12h（P〉0.05）.The incidence rates of adverse reactions of respiratory depression ,tachycardia,intraoperative awareness in the control group were 26.7％（8/30）,50.0％（15/30）,13.3％（4/30）,respectively,which in the observation group were 6.7％（2/30）,20.0％（6/30）,0.0（0/30）,respectively,the differences were statistically significant between the two groups（χ2 =4.320,5.934,5.333,all P〈0.05）.Conclusion Dex combined with oxycodone can ensure good sedation and forgetting effect ,and the incidence rate of adverse reactions is low .