右美托咪定联合盐酸纳布啡用于椎间孔镜手术的麻醉效果及安全性

Effects and Safety of Dexmedetomidine Combined with Nalbphine Hydrochloride in Anesthesia of Percutaneous Transforaminal Endoscopic Discectomy

目的:探讨右美托咪定联合盐酸纳布啡用于椎间孔镜手术的麻醉效果及安全性。方法:选取2017年1月至2017年8月枣阳市第一人民医院收治的择期行椎间孔镜手术的腰椎间盘突出症患者70例作为研究对象,以随机数字表法分为观察组和对照组,每组35例。观察组患者给予右美托咪定联合盐酸纳布啡进行麻醉,对照组患者给予1%利多卡因进行麻醉。比较两组患者麻醉前(T_0)、手术开始时(T_1)、打磨小关节时(T_2)、神经松解时(T_3)及手术结束时(T_4)的平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO_2)、呼吸频率(RR)、视觉模拟评分及Ramsay评分的差异,并于术后2 h随访患者的不良反应发生情况及满意度。结果:T_2、T_3时,观察组患者的HR、MAP明显优于对照组;T_1、T_2、T_3及T_4时,观察组患者的RR明显优于对照组,上述差异均有统计学意义(P<0.05)。T_1、T_2、T_3及T_4时,观察组患者的Ramsay评分明显高于对照组;T_2、T_3时,观察组患者的视觉模拟评分明显低于对照组,上述差异均有统计学意义(P<0.05)。观察组患者不良反应发生率为2.9%(1/35),明显低于对照组的8.6%(3/35),差异有统计学意义(P<0.05);观察组患者满意度为94.3%(33/35),明显高于对照组的77.1%(27/35),差异有统计学意义(P<0.05)。结论:右美托咪定联合盐酸纳布啡用于椎间孔镜手术中的麻醉效果较好。

OBJECTIVE：To probe into the effects and safety of dexmedetomidine combined with nalbphine hydrochloride in anesthesia of percutaneous transforaminal endoscopic discectomy.METHODS：70 patients with protrusion of lumbar intervertebral disc undergoing percutaneous transforaminal endoscopic discectomy admitted into the First People＇s Hospital of Zaoyang from Jan.2017 to Aug.2017 were selected and divided into observation group and control group via random number table,with 35 cases in each.The observation group was given dexmedetomidine combined with nalbphine hydrochloride for anesthesia,while the control group was given 1%of lidocaine.Differences in mean arterial pressure（MAP）,heart rate（HR）,blood oxygen saturation（SpO2）and respiratory rate（RR）,scores of visual analogue scale（VAS）and Ramsay at before anesthesia（T0）,the beginning of operation（T1）,grinding small joints（T2）,mental relaxation（T3）and the end of operation（T4）between two groups were compared.The incidences of adverse drug reactions and patients＇satisfaction degrees were interviewed at 2h after operation.RESULTS：At T2 and T3,the HR and MAP of observation group were significantly better than those of the control group;at T1,T2,T3 and T4,the RR of observation group were significantly better than those of the control group,with statistically significant differences（P〈0.05）.At T1,T2,T3 and T4,the Ramsay scores of observation group were significantly higher than those of the control group;at T2and T3,the VAS scores of observation group were significantly lower than those of the control group,with statistically significant differences（P〈0.05）.The incidence of adverse drug reactions of observation group was 2.9%（1/35）,which was significantly lower than that of the control group（8.6%,3/35）,with statistically significant difference（P0.05）;the satisfaction degree of observation group was 94.3%（33/35）,which was significantly higher than that of the control group（77.1%,27/35）,with statistically significant difference（P〈0.05）.CONCLUSIONS：The effects of dexmedetomidine combined with nalbphine hydrochloride in anesthesia of percutaneous transforaminal endoscopic discectomy is remarkable.