曲马多联合地塞米松超前镇痛用于下肢手术的临床疗效及对睡眠质量的影响

Clinical Efficacy and Effect of Tramadol Combined with Dexamethasone as Advanced Analgesia for Lower Limb Surgery on Sleep Quality

目的:分析曲马多联合地塞米松超前镇痛运用于下肢骨科手术的围术期治疗以及其对睡眠质量的影响。方法:选取2019年1月至2020年3月福建医科大学附属南平市第一医院收治的下肢手术患者60例作为研究对象,按照随机数字表法分为对照组和观察组,每组30例。观察组予以曲马多联合地塞米松,对照组予以同等容量的生理盐水。运用视觉模拟评分(VAS)以及镇痛泵自控按压次数的对比对2组患者的镇痛效果进行评估;另外使用阿森斯失眠量表(AIS)评估患者术后睡眠质量,同时记录患者是否出现恶心、呕吐、眩晕等不适症状。结果:观察组患者的疼痛评分明显低于对照组,观察组患者的静脉自控止痛(PCIA)自控按压次数明显低于对照组。观察组患者睡眠障碍情况显著少于对照组,差异有统计学意义(P<0.05)。结论:将曲马多联合地塞米松用于下肢手术超前镇痛的临床治疗中,能够起到显著的镇痛效果,对患者术后疼痛度减轻及睡眠质量的提升都有促进作用,有利于围术期快速康复,因此具备较好的临床推广价值。

Objective:To analyze the perioperative treatment of tramadol combined with dexamethasone in advanced analgesia for lower limb surgery and its impact on the quality of sleep.Methods:A total of 60 patients with lower limb surgery who were admitted to Nanping First Hospital Affiliated to Fujian Medical University from January 2019 to March 2020 were selected as the research objects and were randomly divided into the control group and the observation group,with 30 cases in each group.The observation group was given tramadol combined with dexamethasone,and the control group was given the same volume of normal saline.The analgesic effect of the two groups of patients was evaluated by using the visual analog scale(VAS)and the comparison of the number of self-controlled compressions of the analgesic pump.In addition,the Athens Insomnia Scale(AIS)was used to evaluate the postoperative sleep quality of the patients,and whether the patients had nausea,vomiting and dizziness were recorded.Results:The pain score in the observation group was significantly lower than that in the control group;patient controlled intravenous analgesia(PCIA)control pressure was significantly lower than that in the control group.The sleep disorders in the observation group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:Tramadol combined with dexamethasone in the clinical treatment of advanced analgesia in lower limb surgery can play a significant analgesic effect,promote postoperative pain reduction and sleep quality,conducive to the development of rapid perioperative rehabilitation,so it has good clinical promotion value.