Objective:To compare the effect of ketamine,lidocaine,acetaminophen,and dexmedetomidine combined with morphine patient-controlled analgesia for opium addicts after tibial fracture surgery.Methods:This double-blind cli...Objective:To compare the effect of ketamine,lidocaine,acetaminophen,and dexmedetomidine combined with morphine patient-controlled analgesia for opium addicts after tibial fracture surgery.Methods:This double-blind clinical trial included opium-addicted patients undergoing tibia fracture surgery.Patients were recruited and randomized to four different groups including the ketamine group,the lidocaine group,the acetaminophen group,and the dexmedetomidine group.The hemodynamic parameters such as heart rate(HR),mean arterial pressure,and arterial SaO2,alongside visual analog scale pain scores,sedation assessed by Ramsay score,nausea and vomiting,and opioid use were recorded and compared among the four groups.Results:This study included 140 patients,aged 37(32,41)years,with 92 males and 48 females,and each group had 35 patients.Dexmedetomidine-sedated subjects had the lowest blood pressure from 1 to 24 h after surgery,decreased HR at 12 and 24 h after surgery,and more satisfactory sedation(P<0.05).Notwithstanding no significant difference was noted in the pain scores,or nausea and vomiting among the groups(P>0.05).Conclusions:Dexmedetomidine has a better sedation effect compared to ketamine,lidocaine,and acetaminophen for pain control,but the final choice hinges on the patients’physical condition and the anesthesiologist's preference.Clinical registration:It is registered in Iranian Registry Clinical Trial by code IRCT20141209020258N146.展开更多
目的探讨舒芬太尼分别联合地佐辛与右美托咪定对胶质瘤手术患者术后唤醒及镇痛的比较。方法选取行胶质瘤手术的46例患者,随机分成D组和Y组,每组23例。在术前结束30 min,D组给予舒芬太尼联合地佐辛镇痛,Y组给予舒芬太尼联合右美托咪定镇...目的探讨舒芬太尼分别联合地佐辛与右美托咪定对胶质瘤手术患者术后唤醒及镇痛的比较。方法选取行胶质瘤手术的46例患者,随机分成D组和Y组,每组23例。在术前结束30 min,D组给予舒芬太尼联合地佐辛镇痛,Y组给予舒芬太尼联合右美托咪定镇痛,观察患者术后唤醒时间、血清致痛物水平,术后视觉模拟评分法(visual analogue scale,VAS)及Ramsay镇静评分,患者镇痛满意率。结果与D组比较,Y组术后唤醒时间较短(P<0.05),术后24、48 h 5-羟色胺水平较高,P物质水平较低(P<0.05),Y组术后24、48 h VAS评分较低(P<0.05),12、24、48 h Ramsay镇静评分较低(P<0.05)。Y组镇痛满意程度显著优于D组,2组比较差异有统计学意义(Z=-2.940,P=0.003<0.01)。D组不良反应总发生5(21.74%)例与Y组4(17.39%)例比较差异无统计学意义。结论舒芬太尼联合右美托咪定对胶质瘤术后有较好的镇痛效果,明显缩短术后唤醒时间及抑制血清致痛物水平,优于舒芬太尼联合地佐辛用药。展开更多
文摘Objective:To compare the effect of ketamine,lidocaine,acetaminophen,and dexmedetomidine combined with morphine patient-controlled analgesia for opium addicts after tibial fracture surgery.Methods:This double-blind clinical trial included opium-addicted patients undergoing tibia fracture surgery.Patients were recruited and randomized to four different groups including the ketamine group,the lidocaine group,the acetaminophen group,and the dexmedetomidine group.The hemodynamic parameters such as heart rate(HR),mean arterial pressure,and arterial SaO2,alongside visual analog scale pain scores,sedation assessed by Ramsay score,nausea and vomiting,and opioid use were recorded and compared among the four groups.Results:This study included 140 patients,aged 37(32,41)years,with 92 males and 48 females,and each group had 35 patients.Dexmedetomidine-sedated subjects had the lowest blood pressure from 1 to 24 h after surgery,decreased HR at 12 and 24 h after surgery,and more satisfactory sedation(P<0.05).Notwithstanding no significant difference was noted in the pain scores,or nausea and vomiting among the groups(P>0.05).Conclusions:Dexmedetomidine has a better sedation effect compared to ketamine,lidocaine,and acetaminophen for pain control,but the final choice hinges on the patients’physical condition and the anesthesiologist's preference.Clinical registration:It is registered in Iranian Registry Clinical Trial by code IRCT20141209020258N146.
文摘目的探讨舒芬太尼分别联合地佐辛与右美托咪定对胶质瘤手术患者术后唤醒及镇痛的比较。方法选取行胶质瘤手术的46例患者,随机分成D组和Y组,每组23例。在术前结束30 min,D组给予舒芬太尼联合地佐辛镇痛,Y组给予舒芬太尼联合右美托咪定镇痛,观察患者术后唤醒时间、血清致痛物水平,术后视觉模拟评分法(visual analogue scale,VAS)及Ramsay镇静评分,患者镇痛满意率。结果与D组比较,Y组术后唤醒时间较短(P<0.05),术后24、48 h 5-羟色胺水平较高,P物质水平较低(P<0.05),Y组术后24、48 h VAS评分较低(P<0.05),12、24、48 h Ramsay镇静评分较低(P<0.05)。Y组镇痛满意程度显著优于D组,2组比较差异有统计学意义(Z=-2.940,P=0.003<0.01)。D组不良反应总发生5(21.74%)例与Y组4(17.39%)例比较差异无统计学意义。结论舒芬太尼联合右美托咪定对胶质瘤术后有较好的镇痛效果,明显缩短术后唤醒时间及抑制血清致痛物水平,优于舒芬太尼联合地佐辛用药。
