国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2014年
7期
920-923
,共4页
舒芬太尼%曲马多%咪达唑仑%预注%椎管内麻醉
舒芬太尼%麯馬多%咪達唑崙%預註%椎管內痳醉
서분태니%곡마다%미체서륜%예주%추관내마취
Sufentanil%Tramadol%Midazolam%Pre-injection%Spinal anesthesia
目的 预注舒芬太尼、曲马多复合咪达唑仑应用于老年髋部骨折手术患者,观察其对椎管内麻醉的影响.方法 选择90例择期老年髋部骨折手术患者,随机分为三组:舒芬太尼组(A组)、曲马多组(B组)和对照组(C组),每组30例.A组给予舒芬太尼0.05～0.1μg/kg、咪达唑仑0.02 ～ 0.03 mg/kg静脉注射,B组给予曲马多0.5 ～ 1.0 mg/kg、咪达唑仑0.02 ～ 0.03 mg/kg静脉注射,C组给予等容量生理盐水,然后实施椎管内麻醉,观察、记录术中生命体征,记录患者给药后疼痛程度和镇静程度及对椎管内麻醉的影响.结果 A组患者在T1时出现SpO2下降,在T1时A组SpO2明显低于B、C组(P＜0.05);C组患者HR、MAP在T1、T2时明显快于、高于T0时(P＜0.05);T1、T2时A、B组HR、MAP明显低于C组(P＜0.05).结论 在实施椎管内麻醉前,在保证充分给氧的情况下,给予舒芬太尼或曲马多复合咪达唑仑,均可以快速、安全、有效地减轻体位转换和侧卧位时髋部疼痛,并消除患者对麻醉、手术及预后的顾虑和恐惧,有利于椎管内麻醉穿刺,抑制患者应激反应,维持血流动力学稳定.患肢在上,又避免体位反复转换对老年患者血流动力学的影响.
目的 預註舒芬太尼、麯馬多複閤咪達唑崙應用于老年髖部骨摺手術患者,觀察其對椎管內痳醉的影響.方法 選擇90例擇期老年髖部骨摺手術患者,隨機分為三組:舒芬太尼組(A組)、麯馬多組(B組)和對照組(C組),每組30例.A組給予舒芬太尼0.05～0.1μg/kg、咪達唑崙0.02 ～ 0.03 mg/kg靜脈註射,B組給予麯馬多0.5 ～ 1.0 mg/kg、咪達唑崙0.02 ～ 0.03 mg/kg靜脈註射,C組給予等容量生理鹽水,然後實施椎管內痳醉,觀察、記錄術中生命體徵,記錄患者給藥後疼痛程度和鎮靜程度及對椎管內痳醉的影響.結果 A組患者在T1時齣現SpO2下降,在T1時A組SpO2明顯低于B、C組(P＜0.05);C組患者HR、MAP在T1、T2時明顯快于、高于T0時(P＜0.05);T1、T2時A、B組HR、MAP明顯低于C組(P＜0.05).結論 在實施椎管內痳醉前,在保證充分給氧的情況下,給予舒芬太尼或麯馬多複閤咪達唑崙,均可以快速、安全、有效地減輕體位轉換和側臥位時髖部疼痛,併消除患者對痳醉、手術及預後的顧慮和恐懼,有利于椎管內痳醉穿刺,抑製患者應激反應,維持血流動力學穩定.患肢在上,又避免體位反複轉換對老年患者血流動力學的影響.
목적 예주서분태니、곡마다복합미체서륜응용우노년관부골절수술환자,관찰기대추관내마취적영향.방법 선택90례택기노년관부골절수술환자,수궤분위삼조:서분태니조(A조)、곡마다조(B조)화대조조(C조),매조30례.A조급여서분태니0.05～0.1μg/kg、미체서륜0.02 ～ 0.03 mg/kg정맥주사,B조급여곡마다0.5 ～ 1.0 mg/kg、미체서륜0.02 ～ 0.03 mg/kg정맥주사,C조급여등용량생리염수,연후실시추관내마취,관찰、기록술중생명체정,기록환자급약후동통정도화진정정도급대추관내마취적영향.결과 A조환자재T1시출현SpO2하강,재T1시A조SpO2명현저우B、C조(P＜0.05);C조환자HR、MAP재T1、T2시명현쾌우、고우T0시(P＜0.05);T1、T2시A、B조HR、MAP명현저우C조(P＜0.05).결론 재실시추관내마취전,재보증충분급양적정황하,급여서분태니혹곡마다복합미체서륜,균가이쾌속、안전、유효지감경체위전환화측와위시관부동통,병소제환자대마취、수술급예후적고필화공구,유리우추관내마취천자,억제환자응격반응,유지혈류동역학은정.환지재상,우피면체위반복전환대노년환자혈류동역학적영향.
Objective To observe the effect of pre-injection of sufentanil or tramadol with midazolam before spinal anesthesia on elderly patients with hip fracture undergoing surgery operation.Methods 90 elderly patients scheduled for selective hip fracture operation were randomly divided into three groups:sufentanil group (group A),tramadol group (group B) and control group (group C),30 cases in each group,group A was pre-intravenous injected with sufentanil 0.05-0.1 μ g/kg,midazolam 0.02-0.03 mg/kg,group B injected with tramadol 0.5-1.0 mg/kg,midazolam 0.02-0.03 mg/kg,and group C was given the equal volume of physiological saline,spinal anesthesia were implemented afterwards,both vital signs and effects on spinal anesthesia during operation were observed and recorded.Results SpO2 decreased at T1 in group A and lower than those in group B and C at T1 (P ＜ 0.05); in group C HR and MAP were obviously faster and higher at T1 and T2 than those at T0 (P ＜ 0.05); in group A and B HR and MAP were obviously lower than those in group C at T1 and T2 (P ＜ 0.05).Conclusion Before spinal anesthesia,ensuring the supply of sufficient oxygen condition,sufentanil or tramadol combined with midazolam can fast,safely and effectively alleviate pain when changing body position and being lateral position,and eliminate the patients' worry and fear about anesthesia,operation and prognosis,they can also improve spinal anesthesia puncturing,inhibit the stress response,and maintain hemodynamic stability.As the affected limb up on,the effect can be avoided on hemodynamics in elderly patients when repeating changing position.
