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编号:13303464
舒芬太尼联合右美托咪啶自控镇痛对老年患者髋部手术术后的镇痛效果和谵妄的影响(1)
http://www.100md.com 2018年5月15日 《中国医学创新》 2018年第14期
     【摘要】 目的:探討舒芬太尼联合右美托咪啶用于术后静脉自控镇痛(PCIA)对老年患者髋部手术术后镇痛效果和谵妄的影响。方法:选取2016年9月-2017年3月在本院行髋部手术的老年患者120例。按照随机数字表法将其分为对照组、观察A组和观察B组,各40例。对照组给予舒芬太尼2 μg/kg、托烷司琼100 μg/kg;观察A组在对照组基础上加用右美托咪定2.5 μg/kg;观察B组舒芬太尼按照1.5 μg/kg配置,其余剂量及药物同观察A组。观察术后镇痛效果(VAS评分)和谵妄发生情况。结果:术后2、8、12 h,对照组VAS评分均明显高于观察A、B组,比较差异均有统计学意义(P<0.05),但观察A、B组VAS评分比较差异均无统计学意义(P>0.05);术后24 h,三组患者VAS评分比较差异均无统计学意义(P>0.05);对照组术后3 d内谵妄总发生率为25.0%,明显高于观察A、B组的5.0%和7.5%,比较差异均有统计学意义(P<0.05);但观察A组、B组谵妄总发生率比较差异无统计学意义(P>0.05)。结论:对行髋部手术的老年患者,采用舒芬太尼联合右美托咪啶进行PCIA的术后镇痛效果显著,且能有效降低术后谵妄的发生,有较高的临床应用价值。
, 百拇医药
    【关键词】 髋部手术; 老年患者; 术后镇痛; 谵妄

    Effect of Sufentanil Combined with Dexmedetomidine for Self-control Analgesia on Analgesic Effect and Delirium after Hip Surgery in Elderly Patients/CHEN Jianting.//Medical Innovation of China,2018,15(14):063-067

    【Abstract】 Objective:To investigate the effect of Sufentanil combined with Dexmedetomidine for patient controlled intravenous analgesia(PCIA) on analgesic effect and delirium after hip surgery in elderly patients.Method:A total of 120 elderly patients underwent hip surgery in our hospital from September 2016 to March 2017 were selected.According to random number table method,they were divided into control group,observation A group and observation B group,40 cases in each group.The control group was given Sufentanil 2 μg/kg and Tropisetron 100 μg/kg,observation A group was added Dexmedetomidine 2.5 μg/kg on the basis of control group,observation B group Sufentanil according to 1.5 μg/kg configuration,and the other doses and drugs were the same as those in observation A group.Postoperative analgesic effect (VAS score) and delirium incidence in three groups were compared.Result:After operation 2,8,12 h,the VAS score of control group were significantly higher than those of observation A and B group,the differences were statistically significant(P<0.05),but the VAS score of observation A and B group were compared,the differences were not statistically significant(P>0.05),after operation 24 h,the VAS score of three groups were compared,the difference was not statistically significant(P>0.05).The total incidence of delirium within 3 d after operation was 25.0% in control group,which was significantly higher than 5.0% and 7.5% in observation A and B group,the differences were statistically significant(P<0.05),but the total incidence of delirium in observation A and B group was compared,the difference was not statistically significant(P>0.05).Conclusion:The use of Sufentanil combined with Dexmedetomidine for PCIA has significant analgesic effect for the elderly patients undergoing hip surgery,and it can effectively reduce the incidence of postoperative delirium,and has a high clinical value., 百拇医药(陈建廷)
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