摘要
目的观察帕瑞昔布钠联合右美托咪定辅助局部麻醉用于老年患者经皮穿刺椎体成形术中的临床效果。方法选择郑州市骨科医院2018年3月至2018年6月收治的60例接受经皮穿刺椎体成形术(PVP)的老年患者作为研究对象,采用随机数字表法将患者分为A组(帕瑞昔布钠+右美托咪定组)和B组(盐水+右美托咪定组),每组30例。两组患者均通过静脉注射右美托咪定镇静,A组术前30min静脉给予帕瑞昔布钠40mg镇痛,B组给予等容量的生理氯化钠溶液。记录患者入手术室静脉注射帕瑞昔布钠(T0)、术前10min静脉泵注右美托咪定(T1)、手术开始(T2)、穿刺椎体时(T3)、手术结束(T4)共5个时点的心率(HR)、平均动脉压(MAP)、脉搏血氧饱和度(SpO2)、视觉模拟疼痛评分(VAS),及两组患者术中的麻醉效果、患者满意度和不良反应发生率。结果A组T2~T4时点的HR、MAP、VAS评分低于B组,术中麻醉效果及患者满意度均优于B组,差异均有统计学意义(P均<0.05)。结论帕瑞昔布钠联合右美托咪定用于老年患者椎体成形术安全可行,血流动力学稳定,麻醉效果好,不良反应少。
Objective To observe the clinic efficacy of parecoxib sodium combined with dexmedetomidine as adjuvant local anesthesia on elderly patients with percutaneous vertebroplasty. Methods A total of 60 patients treated with percutaneous vertebroplasty (PVP) surgeries in Zhengzhou Orthopaedics Hospital from March 2018 to June 2018 were selected as the study objects. They were divided into two groups by random number table method, group A (parecoxib sodium combined with dexmedetomidine) and group B (saline combined with dexmedetomidine), with 30 cases in each group. The two groups were both sedated through intravenous dexmedetomidine. The patients of group A were treated with intravenous parecoxib sodium 40 mg at 30 minutes before the operation. The patients of group B received equivalent volume of saline.The heart rate (HR), mean arterial pressure (MAP), pulse oxygen saturation (SpO2), visual analogue scale (VAS) caore were recorded at 5 time points including after intravenous injection of parecoxib sodium (T0), after intravenous infusion of dexmedetomidine (T1), at the beginning of operation (T2), after puncture vertebral body (T3) and at the end of operation (T4). The anesthetic effect, patient satisfaction and the incidence of adverse reactions of the two groups were recorded. Results In group A, HR, SBP, VAS at T2-T4 were lower than those of group B, the anesthetic effects and patient satisfactions of group A were better than those of group B, and the differences were significant(P<0.05). Conclusions Parecoxib sodium combined with dexmedetomidine in elderly patients undergoing percutaneous vertebroplasty is safe and feasible, with stable hemodynamics, better anaesthesia effect and less adverse reaction.
作者
邵丹
郭瑞
汪凯
Shao Dan;Guo Rui;Wang Kai(Department of Anesthesiology, Zhengzhou Orthopaedics Hospital, Zhengzhou 450000, China;Department of Intensive Care Unit, Zhengzhou Orthopaedics Hospital, Zhengzhou 450000, China;Department of Pain, Zhengzhon Central Hospital, Zhengzhou 450000, China)
出处
《中国实用医刊》
2019年第10期65-68,共4页
Chinese Journal of Practical Medicine
