摘要
目的观察艾司氯胺酮对急诊下肢骨折手术患者麻醉前摆放体位时的镇痛效果。方法选取2021年11月至2022年12月滨州医学院烟台附属医院收治的70例急诊下肢骨折手术患者为研究对象,在组间基线特征可比的原则上,采用随机数字表法分为观察组(麻醉前摆放体位时给予0.25 mg/kg艾司氯胺酮镇痛)和对照组(麻醉前摆放体位时不进行镇痛,给予0.25 mg/kg生理盐水),每组35例。比较分析两组患者进入手术室时(T_(1))、艾司氯胺酮静脉推注10 min后(T_(2))、摆放体位时(T_(3))的疼痛程度以及T_(1)、T_(2)、T_(3)、麻醉平面稳定后5 min(T_(4))的镇静情况。比较分析两组患者的麻醉操作时间、麻醉满意度评分、镇痛泵按压次数以及术后48 h的不良反应发生率。结果T_(1)时刻,两组患者的视觉模拟评分法评分、Ramsay镇静评分比较差异均无统计学意义(P>0.05);T_(2)、T_(3)时刻,观察组患者的视觉模拟评分法评分低于对照组,差异均有统计学意义(P<0.05);T_(2)、T_(3)、T_(4)时刻,观察组患者的Ramsay镇静评分高于对照组,差异均有统计学意义(P<0.05)。观察组患者的麻醉操作时间、镇痛泵按压次数均短于或少于对照组,麻醉满意度评分高于对照组,差异均有统计学意义(P<0.05)。两组患者术后48 h的不良反应发生率比较差异无统计学意义(χ^(2)=0.159,P=0.690)。结论术前应用艾司氯胺酮蛛网膜下腔阻滞可显著减轻急诊下肢骨折手术患者麻醉前摆放体位时的疼痛程度,缩短麻醉操作时间,明显提高患者的麻醉满意度,且安全性较好。
Objective To observe analgesic effect of esketamine on patients with emergency lower limb fracture surgery during positioning before anesthesia.Method 70 patients with emergency lower limb fracture surgery admitted to Yantai Affiliated Hospital of Binzhou Medical University from November 2021 to December 2022 were selected as the study subjects.They were divided into observation group(0.25 mg/kg esketamine for analgesia when positioning before anesthesia)and control group(no analgesia when positioning before anesthesia,given 0.25 mg/kg normal saline)by random number table method,with 35 cases in each group.The pain degree between the two groups were compared when they entered the operating room(T_(1)),10 min after intravenous injection of esketamine(T_(2)),and when they were positioning(T_(3)).The sedation state between the two groups were compared at T_(1),T_(2),T_(3),and the anesthesia plane stabilized 5 min(T_(4)).The anesthesia operation time,anesthesia satisfaction score,the times of analgesic pump compressions and the occurrence of adverse reactions 48 h after surgery were compared between the two groups.Result At T_(1),there were no significant differences in VAS score and Ramsay sedation score between the two groups(P>0.05).At T_(2)and T_(3),the VAS scores in observation group were lower than those in control group,with statistical significance(P<0.05).At T_(2),T_(3)and T_(4),Ramsay sedation scores in observation group were higher than those in control group,with statistical significance(P<0.05).The anesthesia operation time and the times of analgesic pump compressions in observation group were shorter or less than those in control group,and the anesthesia satisfaction score was higher than that in control group,with statistical significance(P<0.05).There was no significant difference in the incidence of adverse reactions 48 h after surgery between the two groups(χ^(2)=0.159,P=0.690).Conclusion The use of esketamine subarachnoid block before surgery can significantly reduce the degree of pain,and shorten the anesthesia operation time,and significantly improve the anesthesia satisfaction of patients with emergency lower limb fracture surgery,with good safety.
作者
王鹏
李玮
黄梅艳
贾树山
Wang Peng;Li Wei;Huang Meiyan;Jia Shushan(The Second School of Clinical Medicine of Binzhou Medical University,Yantai Affiliated Hospital of Binzhou Medical University,Yantai Shandong 264003,China)
出处
《中国医刊》
CAS
2024年第2期181-184,共4页
Chinese Journal of Medicine
基金
山东省医学会科研专项资金项目(YXH2022ZX084)。
