[1]吴赞情,董补怀,刘 瑶△.盐酸右美托咪定对脊柱侧弯矫形术患者血流动力学及术后疼痛的影响*[J].陕西医学杂志,2019,(8):1070-1073.
　WU Zanqing,DONG Buhuai,LIU Yao..Effects of dexmedetomidine hydrochloride on hemodynamics and postoperative pain using before during and after orthomorphia of scoliosis surgery[J].,2019,(8):1070-1073.
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盐酸右美托咪定对脊柱侧弯矫形术患者血流动力学及术后疼痛的影响*
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2019年8期
页码:
1070-1073
栏目:
药物与临床
出版日期:
2019-08-05

文章信息/Info

Title:
Effects of dexmedetomidine hydrochloride on hemodynamics and postoperative pain using before during and after orthomorphia of scoliosis surgery
文章编号:
DOI:10.3969/j.issn.1000-7377.2019.08.031
作者:
吴赞情; 董补怀; 刘 瑶△
西安市红会医院手术麻醉科（西安 710054）
Author(s):
WU Zanqing;  DONG Buhuai; LIU Yao.
Department of Anesthesiology, Xi’an Honghui Hospital（Xi’an 710054）
关键词:
脊柱侧弯; 手术矫正; 盐酸右美托咪定; 血流动力学; 麻醉深度; 术后疼痛
Keywords:
Key words Scoliosis;  Surgical correction; Dexmedetomidine hydrochloride; Hemodynamics; Depth of anesthesia; Postoperative pain
分类号:
R614.2
文献标志码:
A
摘要:
摘 要 目的：探讨应用盐酸右美托咪定对脊柱侧弯矫形术患者血流动力学、麻醉深度及术后疼痛的影响。方法：选取60例脊柱侧弯矫形患者作为研究对象，采用随机数法将其分为两组，即生理盐水对照组（A组）与盐酸右美托咪定组（D组），每组30例。两组患者均给予静吸复合全身麻醉，患者入室后开放外周静脉，A组麻醉诱导前、术中、术后泵注生理盐水，D组麻醉诱导前、术中、术后泵注盐酸右美托咪定。比较两组患者入室（T0）、插管即刻（T1）、切皮时（T2）、手术探查（T3）、拔管时（T4）血压、心率变化及患者镇静程度，以及患者术后3 h(T5)、12 h(T6)、24 h(T7)、48 h(T8)和72 h(T9)疼痛评分。记录两组不良反应发生情况。结果：D组术中平均动脉压及心率在T1～T4各时间点显著低于A组（P＜0.05）；T2～T4时A组平均动脉压及心率间差异存在统计学意义（P＜0.05），但D组平均动脉压及心率间差异无统计学意义（P＞0.05）。D组在T6~T9各时间点的Ramsay评分均明显高于A组（P＜0.05），T5～T9各时间点的VAS评分均明显低于A组（P＜0.05）。与A组比，D组低血压发生率及窦性心动过缓发生率升高，但组间差异无统计学意义（P＞0.05）；但D组高血压发生率明显下降（P＜0.05）。结论：脊柱侧弯矫形手术，麻醉前中后给予盐酸右美托咪定泵入可抑制患者血压及心率波动，提高术中镇静效果，且可显著降低患者术后疼痛的发生，改善患者术后生活质量。
Abstract:
Abstract Objective: Use dexmedetomidine hydrochloride before,during and after orthomorphia of scoliosis surgery and investigate the effects of dexmedetomidine hydrochloride on hemodynamics, depth of anesthesia and pain control. Methods: 60 patients who underwent orthomorphia of scoliosis surgery were selected as the study subjects. The patients were divided into two groups, including saline control group (A) and dexmedetomidine hydrochloride group (D) by random number method, 30 cases in each group. Both groups were given intravenous inhalation combined anesthesia. Peripheral vein was opened after entering the room for each patient. Normal saline was pumped before, during and after induction of anesthesia in A group, and dexmedetomidine hydrochloride was pumped before, during and after induction of anesthesia in D group. Blood pressure, heart rate changes and sedation of 2 groups were compared in terms of admission (T0), intubation (T1), skin incision (T2), surgical exploration (T3), extubation (T4). And pain scores of the 2 groups were recorded at 3 hours (T1), 12 hours (T2), 24 hours (T3), 48 hours (T4) and 72 hours (T5) after operation. The incidence of adverse reactions in both groups was recorded.Results: The mean arterial pressure and heart rate in group D were significantly lower than those in group A at each time point from T1 to T4 (P＜0.05).There was a statistically significant difference in mean arterial pressure and heart rate between group A(P＜0.05), but there was no significant difference in mean arterial pressure and heart rate in group D at the time of T2 to T4 (P>0.05).The Ramsay scores of group D at T6~T9 were significantly higher than those in the group A (P＜0.05),and the VAS scores at T5~T9 were significantly lower than those in the group A (P＜0.05).Compared with group A, the incidence of hypotension and sinus bradycardia in group D increased, but there was no significant difference between the two groups (P>0.05),however, the incidence of hypertension in group D 〖LM〗decreased significantly (P＜0.05).Conclusion: Scoliosis surgery, dexmedetomidine hydrochloride pumping before and after anesthesia can inhibit blood pressure and heart rate fluctuations, improve intraoperative sedative effect, and can significantly reduce postoperative pain and improve postoperative quality of life.

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备注/Memo

备注/Memo:
*陕西省中医管理局中医药研究课题（LCMS016）
更新日期/Last Update: 2019-08-13