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

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1、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

2、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PostoperativeanalgesiceffectofdezocineplustropisetroncombinedwithParecoxibsodiumortramadolinpediclescrewsystemaftertheinternalfixationsurgery.HeZhuowen,LuMoqin,ZengXiaoping,(Depa

3、rtmentofAnesthesiology,ZhaoqingFistPeople’sHospitalZhaoqing526020,China)Abstract:ObjectiveToobservethepostoperativeanalgesiceffectofdezocinecombinedwithParecoxibsodiumortramadolaftertheinternalfixationsurgeryoflumbarspineandtohighlightthesignificanceofcombineduseofdrugsandthetimingofdr

4、ugadministration.Methods:Twohundredcasesreceivingtheinternalfixationsurgeryonthepediclescrewsystemwererandomlydividedintofivegroups,with40casesineachgroup.Differentcombinationsofdrugswereappliedtoobservethepostoperativeanalgesiceffect.Therecoverytime,theVASscoreandRamsaysedationscoreat

5、6,12,24and48hafterrecoveryandtheadversereactionsduringthepostoperativeanalgesiaofallpatientswererecorded.Results:ThepostoperativeanalgesiceffectwasthestrongestingroupⅠ,buttheextubationtime,respiratorydepression,nauseaandvomitting,dizzinessandblurredvisionwerealsothemostserious.Theposto

6、perativeanalgesiceffectwastheworstingroupⅢ,andthenumberofcaseswithpostoperativerestlessnessandwiththedemandforfurtheranalgesicusewasalsothehighest.AcomprehensivecomparisonamonggroupsⅡ,ⅣandⅤshowedthattheanalgesiceffectwasthemostidealingroupⅤ.Conclusion:Throughacomprehensivecomparisonoft

7、hepostoperativeanalgesiceffectamongfivecombinationsofdrugs,itwasfoundthatthebesteffectwasachievedingroupⅤ.Thus,thedrugcombinationofgroupⅤisworthyofpopularizationintheclinicalarea.Keywords:Dezocine,Parecoxibsodium,tramadol,tropisetron,pediclescrewinternalfixation,analgesia［1］术后镇痛应达到安全