摘要
目的:探讨鸡尾酒式药物切口浸润镇痛药在老年脊柱手术患者术后的应用研究。方法:选择2016年1月~2018年12月于我院接受脊柱手术的90例老年患者作为本研究对象,通过随机数表法分为观察组45例和对照组45例,两组均在全麻下完成脊柱手术,对照组术后连接静脉自控镇痛泵进行镇痛;观察组在对照组基础上,在手术结束前,于切口处周围滑膜多点给予混合剂(吗啡+盐酸罗哌卡因注射液+地塞米松注射液+肾上腺素)注射。比较两组术后不同时间点视觉模拟评分法(VAS)评分、Ramsay镇静评分的变化,并比较镇痛泵使用情况及不良反应。结果:观察组在术后2h、6h、12h、24h、48h时,静息时和活动时VAS评分均明显低于对照组,差异有统计学意义;两组术后不同时间点Ramsay镇静评分比较差异均无统计学意义;观察组术后镇痛泵有效按压次数、总按压次数明显低于对照组;观察组不良反应总发生率明显低于对照组。结论:鸡尾酒式药物切口浸润镇痛用于老年脊柱手术中效果显著,可获得满意的镇痛、镇静效果,且可减少阿片类药物所带来的不良反应,安全性高,值得应用推广。
Objective To study the application research of cocktail style incision infiltration analgesics in treatment of the spinal surgery in the elderly patients.Methods 90 cases of elderly patients who underwent spinal surgery from January 2016 to December 2018 in our hospital were selected as research objects,according to the random number table,those patients were divided into the 45 cases of the observation group and 45 cases of the control group,they were completed in spinal surgery under general anesthesia,the control group received analgesia via intravenous controlled analgesia pump after operation,on the basis of the control group,the observation group was injected with a mixture (morphine+ropivacaine hydrochloride injection+Dexamethasone injection+adrenaline) at multiple points around the incision before the end of the operation.The changes of VAS score and Ramsay sedation score at different time points after operation were compared between the two groups,and the use of analgesic pump and adverse reactions were compared.Results At after operation 2h,6h,12h,24h and 48h,the VAS scores at rest and activity in the observation group were significantly lower than those in the control group and the difference was statistically significant;there was no significant difference in Ramsay sedation score between the two groups at different time points after operation;the effective pressing times and total pressing times of analgesic pump in observation group were significantly less than those in control group;the total incidence of adverse reactions in the observation group was significantly lower than thosein the control group.Conclusion The cocktail style incision infiltration analgesics is well for the elderly patients with spinal surgery,the analgesic and sedative effects are satisfactory,and the adverse reactions caused by opioids can be reduced,ti’s safe and worth popularizing.
作者
张帅
Zhang Shuai(Department of anesthesia,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)
出处
《湖南师范大学学报（医学版）》
2021年第1期65-68,共4页
Journal of Hunan Normal University(Medical Sciences)
关键词
老年
脊柱手术
鸡尾酒式
镇痛
elderly
spinal surgery
cocktail style
analgesia
