目的 探究地佐辛在老年压缩性腰椎骨折全麻手术中的预防性镇痛效果及对患者康复的影响。方法 选取2018年1-12月在武警河南总队医院行手术治疗的老年压缩性腰椎骨折患者100例,按随机数字表法分为芬太尼组和地佐辛组,每组50例。术前及术中给予两组不同剂量的麻醉药物,观察两组手术相关情况及实验室指标变化情况。结果 两组麻醉时间、拔管时间、清醒时间及意识恢复时间对比,差异均无统计学意义。在术后缝皮时,术后1 h、24 h,两组间的血糖水平、血乳酸水平、血浆肾上腺素浓度、去甲肾上腺素浓度和皮质醇浓度相比,差异均有统计学意义(P<0.05)。术后4 h、8 h和24 h,地佐辛组的视觉模拟疼痛评分低于芬太尼组(P<0.05)。地佐辛组不良反应总发生率低于芬太尼组,患者满意度高于芬太尼组,差异均有统计学意义(P<0.05)。结论 在老年压缩性腰椎骨折全麻手术中采用地佐辛静脉注射有较好的术后预防镇痛效果,且不良反应少、患者满意度高。
Abstract
Objective To explore the effect of dizoxine on prophylactic analgesia and on rehabilitation of elderly patients undergoing general anesthesia for compression lumbar fractures.Methods Between January 2018 and December 2018, 100 cases of elderly patients with compression fractures of the lumbar spine who underwent surgery in our hospital were sellected as the subjects. These patients were randomly divided into the fentanyl group and dizoxin group. Preoperative and intraoperative patients were given different doses of anesthetic drugs to observe the changes of their surgical conditions and laboratory indicators.Results There was no difference in the duration of anesthesia, time for extubation, waking hours and the time taken to recover consciousness between the two groups. The blood glucose level, blood lactic acid level, plasma adrenalin concentration, norepinephrine concentration and cortisol concentration were significantly different between the two groups at the time of suture, 1 h and 24 h after surgery (P<0.05). At 4 h, 8 h and 24 h after surgery, the visual analogue pain score in the dizoxin group was significantly lower than that in the fentanyl group (P<0.05). The incidence of adverse reactions in the dizoxin group was significantly lower than that in the fentanyl group (P<0.05). The satisfaction rate of patients in the dizoxin group was 92%, which was significantly higher than that of the fentanyl group (P<0.05).Conclusions During general anesthesia surgery for compression lumbar fractures in the elderly, intravenous dizoxine injection 15 minutes before surgical incisions can obtain good postoperative analgesic and preventive effects, with fewer adverse reactions and higher levels of patient satisfaction, which is worthy of clinical application.
关键词
全身麻醉 /
地佐辛 /
复杂腰椎骨折 /
镇痛 /
康复效果
Key words
general anesthesia /
dizoxine /
complex lumbar fracture /
analgesia /
effect of rehabilitation
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