中国医师杂志
中國醫師雜誌
중국의사잡지
JOURNAL OF CHINESE PHYSICIAN
2013年
z1期
15-17
,共3页
多模式镇痛%老年患者%全髋置换术
多模式鎮痛%老年患者%全髖置換術
다모식진통%노년환자%전관치환술
Multi-model analgesia%The old patients%Total hip replacement
目的 观察硬膜外单次推注长效局部麻醉药和吗啡联合持续静脉镇痛的多模式镇痛方式对老年全髋置换患者的镇痛效果.方法 腰硬联合麻醉下行全髋置换术的老年患者,分为硬膜外镇痛组(E组)和多模式镇痛组(M组).M组镇痛方法为:手术结束前30min经硬膜外导管加入0.15％罗哌卡因加吗啡1mg共5ml,手术结束时拔除硬膜外导管佩带静脉镇痛泵.记录各时点的镇痛评分(NRS)、镇静评分及心率、平均动脉压、呼吸频率、脉搏氧饱和度;48h内恶心呕吐等不良反应的发生情况及需要追加镇痛药物的例数.结果 在T2时点M组患者翻身时的NRS评分低于E组;在T1、T2时点M组的镇静评分较E组高;在T1时点M组SpO2较E组低.结论 硬膜外单次推注长效局部麻醉药和阿片类药物继之以舒芬太尼复合曲马多静脉泵注的多模式镇痛方式可以安全的用于老年全髋置换术的患者,且效果确切.
目的 觀察硬膜外單次推註長效跼部痳醉藥和嗎啡聯閤持續靜脈鎮痛的多模式鎮痛方式對老年全髖置換患者的鎮痛效果.方法 腰硬聯閤痳醉下行全髖置換術的老年患者,分為硬膜外鎮痛組(E組)和多模式鎮痛組(M組).M組鎮痛方法為:手術結束前30min經硬膜外導管加入0.15％囉哌卡因加嗎啡1mg共5ml,手術結束時拔除硬膜外導管珮帶靜脈鎮痛泵.記錄各時點的鎮痛評分(NRS)、鎮靜評分及心率、平均動脈壓、呼吸頻率、脈搏氧飽和度;48h內噁心嘔吐等不良反應的髮生情況及需要追加鎮痛藥物的例數.結果 在T2時點M組患者翻身時的NRS評分低于E組;在T1、T2時點M組的鎮靜評分較E組高;在T1時點M組SpO2較E組低.結論 硬膜外單次推註長效跼部痳醉藥和阿片類藥物繼之以舒芬太尼複閤麯馬多靜脈泵註的多模式鎮痛方式可以安全的用于老年全髖置換術的患者,且效果確切.
목적 관찰경막외단차추주장효국부마취약화마배연합지속정맥진통적다모식진통방식대노년전관치환환자적진통효과.방법 요경연합마취하행전관치환술적노년환자,분위경막외진통조(E조)화다모식진통조(M조).M조진통방법위:수술결속전30min경경막외도관가입0.15％라고잡인가마배1mg공5ml,수술결속시발제경막외도관패대정맥진통빙.기록각시점적진통평분(NRS)、진정평분급심솔、평균동맥압、호흡빈솔、맥박양포화도;48h내악심구토등불량반응적발생정황급수요추가진통약물적례수.결과 재T2시점M조환자번신시적NRS평분저우E조;재T1、T2시점M조적진정평분교E조고;재T1시점M조SpO2교E조저.결론 경막외단차추주장효국부마취약화아편류약물계지이서분태니복합곡마다정맥빙주적다모식진통방식가이안전적용우노년전관치환술적환자,차효과학절.
Objective To study the effects of the multi-model analgesia for the old patients who received total hip replacement surgery.Methods Thiry-four patients who would received total hip replacement surgery were randomly divided into 2 group:Group E was the epidural analgesia group and Group M was the multi-model analgesia group.15min before the end of surgery,the load doses were given to the patients in both groups and the electric pumps for postoperative analgesia were connected.The multi-model analgesia was used for Group M:30min before the end of surgery,ropivacaine 7.5mg and morphine 1mg were given via epidural catheter,and at the end of surgery the catheter was pulled out.Intravenous analgesic pumb were used for Group M.Record the following data at different time point (T1 to T5):(1)the pain scores.(2)the scores of sedation and HR,MAP,RR and SpO2.(3)the numbers of the patients who suffered from adverse effects,such as nausea and vomiting and the numbers of patients who needed the rescue medicine were recorded in 48h after surgery.Results Compared to Group E,the scores of pain when the patients turned over in Group M,were lower significantly at T2.At T1 and T2 time point,the sedation scores of Group M were higher than those of Group E significantly.There was significant difference in the SpO2 change between groups at T1.Conclusion The multi-model analgesia of using long-acting local anesthetics and opioids for epidural analgesia once,then using sufentanil and tramadal for intravenous analgesia continuously,was safe and sufficient for the old patients.
