地佐辛联合帕瑞昔布钠或曲马多于腰椎内固定术后的镇痛效果比较教学.docVIP

地佐辛加托烷司琼联合帕瑞昔布钠或曲马多于椎弓根钉系统内固定术术后镇痛效果观察 何卓文 李么琴 曾晓萍 【摘要】目的 比较地佐辛联合帕瑞昔布钠或曲马多不同配伍于腰椎内固定术后镇痛的效果，强调药物联合使用及注药时机的重要性。方法 将200例需行椎弓根钉系统内固定术的病例随机分五组，每组40例，分别实施不同药物配伍的术后静脉镇痛方法。观察并记录每位患者术后复苏情况及苏醒后、6、12、24、48h各时间点的VAS评分、Ramsay镇静评分，还有术后镇痛期间的不良反应等。结果 术后镇痛镇静以Ⅰ组最强，但术后拔管耗时、呼吸抑制、恶心呕吐和头晕视蒙也最严重；Ⅲ组镇镇痛效果最差，术后躁动和需追加镇痛药病例也最多；综合比较Ⅱ、Ⅳ、Ⅴ组，以Ⅴ组药物配方的效果最为理想。 结论 通过五组方案效果的综合比较，第Ⅴ组镇痛方案效果最显著，最具临床推广价值。 【关键词】 地佐辛；帕瑞昔布钠；曲马多；托烷司琼；椎弓根钉内固定术；镇痛 Postoperative analgesic effect of dezocine plus tropisetron combined with Parecoxib sodium or tramadol in pedicle screw system after the internal fixation surgery. He Zhuowen, Lu Moqin, Zeng Xiaoping, (Department of Anesthesiology,Zhaoqing Fist People’s Hospital Zhaoqing 526020,China) Abstract: Objective To observe the postoperative analgesic effect of dezocine combined with Parecoxib sodium or tramadol after the internal fixation surgery of lumbar spine and to highlight the significance of combined use of drugs and the timing of drug administration. Methods: Two hundred cases receiving the internal fixation surgery on the pedicle screw system were randomly divided into five groups, with 40 cases in each group. Different combinations of drugs were applied to observe the postoperative analgesic effect. The recovery time, the VAS score and Ramsay sedation score at 6, 12, 24 and 48h after recovery and the adverse reactions during the postoperative analgesia of all patients were recorded. Results: The postoperative analgesic effect was the strongest in group Ⅰ, but the extubation time, respiratory depression, nausea and vomitting, dizziness and blurred vision were also the most serious. The postoperative analgesic effect was the worst in group Ⅲ, and the number of cases with postoperative restlessness and with the demand for further analgesic use was also the highest. A comprehensive comparison among groups Ⅱ, Ⅳ and Ⅴ showed that the analgesic effect was the most ideal in group Ⅴ. Conclusion: Through a comprehensive comparison of the postoperative analgesic eff