右美托咪定复合舒芬太尼在脊柱后凸畸形矫形术中的应用

Dexmedetomidine combined with sufentanil in orthopedic surgery for kyphosis

目的:探讨右美托咪定复合舒芬太尼在脊柱后凸畸形矫形术中的应用效果。方法:脊柱后凸畸形矫形术患者150例,完成手术前30 min,将进行舒芬太尼自控静脉镇痛的75例患者纳入对照组,进行右美托咪定复合舒芬太尼自控静脉镇痛的75例患者纳入观察组。比较两组苏醒质量、术后不同时间段疼痛情况、血流动力学指标变化情况及不良反应发生率。结果:观察组苏醒时间和拔管时间均短于对照组(P<0.05),咳呛评分和唤醒质量评分小于对照组(P<0.05);术后12、24及48 h,观察组视觉模拟评分(VAS)均低于对照组(P<0.05);与T0相比,两组T1~T3平均动脉压(MAP)均上升(P<0.05),观察组MAP变化小于对照组(P<0.05);与T0相比,对照组T1~T3心率(HR)升高(P<0.05),观察组HR仅T3时比较差异有统计学意义(P<0.05),且观察组T1~T3时HR均低于对照组(P<0.05);观察组术后不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。结论:右美托咪定复合舒芬太尼在脊柱后凸矫形术中具有较高应用价值,不仅有利于改善患者苏醒质量,稳定血流动力学波动,同时在保证镇痛效果理想的前提下,还可减少术后不良事件风险,可广泛应用于临床。

Objective:To investigate the efftcts of dexmedetomidine combined with sufentanil in orthopedic surgery for kyphosis.Methods:Totally 150 patients undergoing orthopedic surgery for kyphosis in the hospital were selected as the research subjects.30 minutes before the completion of the operation,75 patients undergoing sufentanil patient controlled intravenous analgesia were included in the control group,and 75 patients undergoing dexmedetomidine combined with sufentanil patient controlled intravenous analgesia were included in the observation group.The recovery quality,pain at different time after surgery,changes in hemodynamic indicators and the incidence of adverse reactions were compared between the two groups.Results:The recovery time and extubation time of the observation group were shorter than those of the control group(P<0.05),and the scores of bucking and arousal quality were lower than those of the control group(P<0.05).The observation group had significantly lower visual analogue scale(VAS)scores than the control group at 12,24 and 48 h after surgery(P<0.05).Compared with T0,the mean arterial pressure(MAP)of the two groups increased significantly from T1 to T3(P<0.05),but the change in MAP of the observation group was significantly smaller than that of the control group(P<0.05).Compared with T0,the heart rate(HR)of the control group increased significantly from T1 to T3(P<0.05),and there was a statistically significant difference in HR of the observation group only at T3(P<0.05).The observation group had lower HR than the control group from T1 to T3(P<0.05).The total incidence of adverse reactions in the observation group was lower than that in the control group(P<0.05).Conclusion:Dexmedetomidine combined with sufentanil has a high application value in kyphosis correction surgery.It is not only beneficial to improve the patient’s recovery quality,stabilize hemodynamic fluctuations,and at the same time ensure the ideal analgesic effect,but also it can reduce the risk of postoperative adverse events and can be widely used in clinics.