右美托咪定配合曲马多在瑞芬太尼麻醉后痛觉过敏的临床效果分析

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• 论文作者：叶智
• 年：2016
• 作者机构：内江市隆昌县人民医院;
• 论文关键词：右美托咪定 ; 曲马多 ; 瑞芬太尼 ; 痛觉过敏
• 英文论文关键词：Dexmedetomidine ; tramadol ; remifentanil ; hyperalgesia
• 会议召开时间：2016-11-25
• 会议录名称：湖南中医药大学学报2016/专集：国际数字医学会数字中医药分会成立大会暨首届数字中医药学术交流会论文集
• 语种：中文
• 分类号：R614
• 学会代码：HNZY
• 会议名称：国际数字医学会数字中医药分会成立大会暨首届数字中医药学术交流会
• 会议地点：中国广东珠海
• 主办单位：国际数字医学会、Digital Chinese Medicine
• 学会名称：湖南中医药大学期刊杂志社
• 页数：1
• 文件大小：1903k
• 原文格式：D
• 会议级别：全国

摘要

目的:研究右美托咪定配合曲马多在瑞芬太尼麻醉后痛觉过敏的临床效果。方法:选取医院内部2015年1月~2016年1月收治的140例采取瑞芬太尼麻醉行手术的患者进行临床研究。采用电脑随机抽取的方式将其分为A组研究组,B组对照组,所有患者行静脉全麻手术,术前禁食禁水,静脉注射咪达唑仑0.04mg/kg、丙泊酚1.5mg/kg、瑞芬太尼1μg/kg,采用静脉注射顺式阿曲库铵0.15mg/kg行麻醉。术中以瑞芬太尼0.2μg·kg-1·min-1恒定剂量持续静脉泵注,丙泊酚以5~12mg·kg-1·h-1持续静脉泵注,间断静脉注射顺式阿曲库铵0.07mg/kg以维持肌松。A组患者手术结束前0.5h采用恒速泵注射右美托咪定(0.5μg/kg)10min,静脉注射曲马多1mg/kg;B组患者在手术结束前0.5h静脉注射曲马多1mg/kg。结果:两组患者拔出气管时(T1),拔出气管后5min(T2),拔出气管后10min(T3)HR和MAP组间比较差异明显,具有统计学意义(P<0.05);两组患者术后30min(T1),术后60min(T2),术后90min(T3)VAS评分A组明显低于B组,组间差异明显,具有统计学意义(P<0.05);两组患者术后不良反A组各项不良反应率明显低于B组,组间比较差异具有统计学意义(P<0.05)。结论:右美托咪定配合曲马多在瑞芬太尼麻醉后痛觉过敏临床效果研究中能够提供阵痛、镇静的作用,预防痛觉过敏,效果显著,不良反应率低,具有临床应用及推广的价值。
Objective: To investigate the effect of dexmedetomidine combined with tramadol clinical effect on hyperalgesia after remifentanil anesthesia. Methods: from January 2015 to January 2016 within the hospital treated 140 cases of surgical patients take remifentanil anesthesia in clinical study. Using the computer randomly chosen way can be divided into A group, B group and control group all patients received intravenous anesthesia, surgery, preoperative fasting, intravenous injection of midazolam 0.04mg/kg, propofol 1.5mg/kg and remifentanil 1 g/kgby intravenous injection of cisatracurium anesthesia for 0.15mg/kg. Operation with remifentanil 0.2 g- kg- 1- min- 1 constant dose intravenous infusion of propofol in 5 ~ 12mg- kg- 1- H- 1 continuous intravenous infusion and intermittent intravenous injection of cisatracurium 0.07mg/kg to maintain muscle relaxant group.A 0.5h before the end of the constant speed pump injectiondexmedetomidine(0.5 g/kg 10min), intravenous injection of tramadol 1mg/kg; B group 0.5h before the end of intravenous injection of tramadol 1mg/kg. Results in surgery: Two groups of patientsout of the trachea(T1), 5min(T after pulling out the tracheal 2), after pulling out the tracheal 10 min HR MAP(T3) and the difference between groups was significant, with statistical significance(P < 0.05); the two groups of patients after 30min(T1), 60 min after operation(T2), postoperative 90min(T3) VAS score of A group was significantly lower than that in group B, the differences betweengroups obviously, with statistical significance(P < 0.05); two groups of patients with postoperative adverse reaction in A group the adverse reaction rate was significantly lower than that in group B, the difference was statistically significant(P < 0.05). Conclusion: Dexmedetomidine combined with tramadol analgesia after remifentanil anesthesia in the clinical effect of allergy The researchcan provide labor pains, the role of sedation, prevention of pain, the effect is obvious, the adverse reaction rate is low, with clinical application and promotion of value.

引文

[1]王瑜,蒋蓉,邓佳,等.右美托咪定联合帕瑞昔布钠预防瑞芬太尼麻醉后痛觉过敏[J].临床麻醉学杂志,2014,12(01):1152-1155.
    [2]仲俊峰,胡双燕,蒋宗明.右美托咪定和氯胺酮预防瑞芬太尼麻醉后痛觉过敏效果的比较[J].中国现代应用药学,2014,02(05):234-237.
    [3]杨晴,林旭红,丁涛,等.右美托咪定用于预防瑞芬太尼停药后痛觉过敏的效果观察[J].中国当代医药,2014,29(04):83-85.
    [4]张卫,周立君,阚全程,等.不同剂量右美托咪定与小剂量氯胺酮预防瑞芬太尼复合麻醉后痛觉过敏的效果比较[J].临床麻醉学杂志,2013,05(03):435-438.
    [5]林莹,陈彦青,戴双波.舒芬太尼复合右美托咪定妇科腔镜手术术后镇痛效果观察[J].临床麻醉学杂志,2011,07(02):690-692.
    [6]李庆忠,杨淑玲,王希娥.右美托咪定联合曲马多预防瑞芬太尼麻醉后痛觉过敏的临床研究[J].中国全科医学,2014,29(06):3514-3517.