酒石酸布托啡诺复合地佐辛用于全髋置换术后自控镇痛的效果观察

Analgesia Effects of Bhutto Butorphanol Tartrate Combined Dezocine in Patients after Total Hip Replacement

关键词:  酒石酸布托啡诺  地佐辛  全髋置换术  自控镇痛  镇静

Key words:  bhutto butorphanol tartrate  dezocine  total hip replacement  analgesia  sedation

摘要:

目的 观察酒石酸布托啡诺复合地佐辛应用于全髋置换术后自控镇痛的效果。方法 采用回顾性研究，选择2015年8月到2018年1月在湖北医药学院附属东风医院择期行全髋置换术的患者58例作为研究对象，根据术后镇痛药物的不同分为观察组30例与对照组28例，2组在手术中都采用腰-硬联合麻醉，对照组给予术后地佐辛硬膜外自控镇痛，观察组给予术后酒石酸布托啡诺复合地佐辛硬膜外自控镇痛，记录2组镇痛效果与预后情况。结果 观察组术后2，6，12，24 h的疼痛VAS评分都显著低于对照组（P<0.05）。术后不同时间点，2组在Ramsay镇静评分方面没有明显差异。在术后的尿潴留、瘙痒、呼吸抑制、恶心呕吐等不良反应发生率上，观察组为6.7%，对照组为53.6%，观察组显著低于对照组（P<0.05）。2组术前1 d肾上腺素与去甲肾上腺素对比无显著差异，术后24 h都显著增加，术后72 h逐渐恢复到术前1 d水平，观察组的波动幅度显著小于对照组（P<0.05）。结论 地佐辛联合酒石酸布托啡诺应用于全髋置换术后自控镇痛能在保持镇静效果的基础上提高镇痛效果，缓解机体应激反应，减少术后不良反应的发生率。

Abstract:

OBJECTIVE To observe theanalgesia effects of bhutto butorphanol tartrate combined dezocine in the patients after total hip replacement. METHODS From August 2015 to January 2018, used the retrospective research methods, 58 patients underwent total hip replacement were selected in Dongfeng Hospital Affiliated to Hubei University of Medicine as the research object, all the patients were divided into the observation group of 30 patients and the control group of 28 patients accorded to the different postoperative analgesic drugs, two groups were given the combined spinal epidural anesthesia, the control group were given postoperative dezocine epidural analgesia, the observation group were given postoperative bhutto butorphanol tartrate combined dezocine epidural analgesia, recorded two groups of analgesic effect and prognosis. RESULTS The postoperative 2, 6, 12 and 24 h pain VAS scores in the observation group were significantly less than those in the control group(P<0.05). There were no significant difference in the contrast of Ramsay scores at different time points between the two groups. The incidence of adverse reactions of postoperative such as urinary retention, itching, respiratory depression, nausea and vomiting was 6.7% in the observation group, while it was 53.6% in the control group. The incidence in the observation group were significantly lower than that in the control group(P<0.05). There were no significant difference between the two groups in preoperative 1 d adrenaline and norepinephrine, and at postoperative 24 h they were increased significantly, and at postoperative 72 h they were gradually returned to the level of preoperative 1 d. The fluctuation amplitude of the observation group were significantly less than that of the control group(P<0.05). CONCLUSION The bhutto butorphanol tartrate combined dezocine for postoperative analgesia in patients undergoing total hip replacement can enhance the analgesic effect in maintaining sedative effect, relieve stress response, reduce the incidence of adverse reactions after operation.