摘要
目的:分析超声引导下星状神经节阻滞联合右美托咪定对髋关节置换术后麻醉趋势指数和疼痛程度的影响。方法:选取大连市第三人民医院2018年1月至2019年6月行髋关节置换患者70例,按随机数字表法分为对照组和试验组,每组35例。对照组于麻醉诱导前静脉泵注0.25μg/(kg·h)右美托咪定;试验组于麻醉诱导前超声引导下星状神经节阻滞联合静脉泵注0.25μg/(kg·h)右美托咪定。比较两组麻醉恢复情况、麻醉趋势指数、疼痛程度及不良反应。结果:试验组手可指鼻时间、自主呼吸恢复时间、抬头时间和呼之睁眼时间均明显短于对照组[(17.78±2.33)min比(22.07±2.59)min、(2.50±0.51)min比(3.61±0.58)min、(12.01±1.33)min比(18.01±2.05)min和(7.35±1.18)min比(9.53±1.46)min],差异有统计学意义(P<0.01)。两组入手术室时麻醉趋势指数比较差异无统计学意义(P>0.05);试验组插管时、插管后5 min和术毕前10 min麻醉趋势指数均明显高于对照组(95.15±3.66比89.77±4.39、90.36±3.71比86.44±4.28和88.50±4.06比82.22±4.17),差异有统计学意义(P<0.01)。试验组术后4、8、12、24和48 h静态和动态疼痛视觉模拟评分均明显低于对照组,差异有统计学意义(P<0.01)。试验组未发生明显与超声引导下星状神经节阻滞相关的不良反应。结论:超声引导下星状神经节阻滞联合右美托咪定在髋关节置换术中的麻醉效果显著,可促进患者术后恢复,改善麻醉趋势指数和疼痛程度。
Objective:To analyze the effect of ultrasound-guided stellate ganglion block combined with dexmedetomidine on Narcotrend index and pain degree after hip replacement.Methods:Seventy patients who underwent hip replacement in the Third People′s Hospital of Dalian City from January 2018 to June 2019 were selected.The patients were divided into control group and experimental group by random digits table with 35 cases in each group.Before induction of anesthesia,the patients in control group were given dexmedetomidine 0.25μg/(kg·h)venous pump injection;the patients in experimental group were anesthetized by ultrasound-guided stellate ganglion block combined with dexmedetomidine 0.25μg/(kg·h).The anesthesia recovery,Narcotrend index pain degree and adverse reaction were compared between 2 groups.Results:The postoperative finger-pointing-nose time,spontaneous breath recovery time,head up time and eye opening time in experimental group were significantly shorter than those in control group:(17.78±2.33)min vs.(22.07±2.59)min,(2.50±0.51)min vs.(3.61±0.58)min,(12.01±1.33)min vs.(18.01±2.05)min and(7.35±1.18)min vs.(9.53±1.46)min,and there were statistical differences(P<0.01).There was no statistical difference in the Narcotrend index at the time of going into the operating room between 2 groups(P>0.05);the Narcotrend index at the time of intubation,5 min after intubation and 10 minutes before conclusion of the surgical procedure in experimental group was significantly higher than that in control group(95.15±3.66 vs.89.77±4.39,90.36±3.71 vs.86.44±4.28 and 88.50±4.06 vs.82.22±4.17),and there was statistical difference(P<0.01).The static and dynamic visual analogue score 4,8,12,24 and 48 h after operation in experimental group was significantly lower than that in control group,and there was statistical difference(P<0.01).No adverse reaction associated with ultrasound-guided stellate ganglion block was observed in the experimental group.Conclusions:Ultrasound-guided stellate ganglion block combined with dexmedetomidine has a significant anesthetic effect in hip replacement patients,which can promote postoperative recovery,as well as improve Narcotrend index and pain level.
作者
戚晓彤
Qi Xiaotong(Department of Anaesthesiology,the Third People's Hospital of Dalian City,Dalian 116000,China)
出处
《中国医师进修杂志》
2020年第11期1040-1044,共5页
Chinese Journal of Postgraduates of Medicine
