CAJ | 학술논문

目的探讨新疆维族和汉族间民族差异对患者脊柱手术后镇痛药量和效果的影响. 方法选择美国麻醉医师协会(ASA)Ⅰ或Ⅱ级择期在全身麻醉下行后路全椎板切除、髓核摘除加椎间植骨椎弓根内固定术患者94例,并按民族分为两组:汉族组(H组)和维族组(U组),每组各47例.术后采用芬太尼静脉自控镇痛,记录并比较术后6、12、24、48 h的视觉模拟评分(visual analogue scale,VAS)、Ramsay镇静评分、生命体征、副作用、48 h患者自控镇痛(patient-controlled analgesia,PCA)总按压次数、有效按压次数和芬太尼总用量. 结果两组患者各时间点平均动脉压(mean artery pressure,MAP)、脉搏血氧饱和度(pulse oxygen saturation,SpO2)、Ramsay评分和VAS评分比较差异无统计学意义(P＞0.05);U组PCA总按压次数、有效按压次数和芬太尼总用量[(21.8±6.8)、(13.2±3.0)次和(1 203±217) μg]均明显多于H组[(12.5±3.2)、(7.9±2.6)次和(793±138) μg](P＜0.05);与H组7例(15％)比较,U组12例(27％)术后恶心呕吐发生率明显增多(P＜0.05). 结论维族与汉族患者术后静脉镇痛芬太尼需要量差异有统计学意义,临床用量应考虑民族差异的影响.
목적 탐토신강유족화한족간민족차이대환자척주수술후진통약량화효과적영향. 방법 선택미국마취의사협회(ASA)Ⅰ혹Ⅱ급택기재전신마취하행후로전추판절제、수핵적제가추간식골추궁근내고정술환자94례,병안민족분위량조:한족조(H조)화유족조(U조),매조각47례.술후채용분태니정맥자공진통,기록병비교술후6、12、24、48 h적시각모의평분(visual analogue scale,VAS)、Ramsay진정평분、생명체정、부작용、48 h환자자공진통(patient-controlled analgesia,PCA)총안압차수、유효안압차수화분태니총용량. 결과 량조환자각시간점평균동맥압(mean artery pressure,MAP)、맥박혈양포화도(pulse oxygen saturation,SpO2)、Ramsay평분화VAS평분비교차이무통계학의의(P＞0.05);U조PCA총안압차수、유효안압차수화분태니총용량[(21.8±6.8)、(13.2±3.0)차화(1 203±217) μg]균명현다우H조[(12.5±3.2)、(7.9±2.6)차화(793±138) μg](P＜0.05);여H조7례(15％)비교,U조12례(27％)술후악심구토발생솔명현증다(P＜0.05). 결론 유족여한족환자술후정맥진통분태니수요량차이유통계학의의,림상용량응고필민족차이적영향.
Objective To compare dosage and effects of postoperative analgesia between patients of Uygur and Han nationalities after spinal surgery.Methods Ninty-four ASA Ⅰ or Ⅱ patients(47 Uygur nationality,47 Han nationality) undergoing posterior laminectomy,discectomy interbody pedicle fixation operation under general anesthesia were divided into two groups (U and H).The patients in both groups received fentanyl patient-controlled intravenous analgesia after surgery.Visual analog scale (VAS),Ramsay sedation scale score,the vital signs at 6,12,24,48 h after operation and the total consumption of fentanyl,the total number and the valid number of pressing patient-controlled analgesia (PCA) pump,the adverse effects at 48 h after operation were recorded and compared.Results There were no difference in the mean artery pressure (MAP),pulse oxygen saturation(SpO2),Ramsay score and VAS score at the time points of patients between two groups (P＞0.05).The total consumption of fentanyl,the total number and the valid number of pressing PCA pump (times) in group U were (1 203±217) pg,(21.8±6.8),(13.2±3.0) respectively.It was significantly higher than those of group H,which were (793±138) μg,(12.5±3.2),(7.9±2.6) respectively.Compared with group H (15％),the occurrence rate of postoperative nausea and vomiting in group U (27％)was significantly higher (P＜0.05).Condusions There is a significant difference in the total consumption of fentanyl between Uygur and Han nationalities.The influence of nationality on recommended dosage of fentanyl should be considered.