CAJ | 학술논문

目的：探讨后颅窝手术患者曲马多复合右美托咪定术后镇痛减少曲马多用量的可行性。方法40例拟行择期后颅窝手术的患者分为右美托咪定组（A组）和对照组（B组）。A组患者术后采用曲马多复合右美托咪定静脉泵入镇痛，减少曲马多用量；B组单用曲马多静脉泵入镇痛。观察两组患者术前，术后1、6、12、24、48 h VAS评分、Ramsay评分、心率、血压、呼吸频率、SpO2等生命体征变化及恶心呕吐等术后并发症的发生情况，并进行统计学分析，评价两组患者术后镇痛镇静的效果。结果VAS评分术后各时间点，组间差异无统计学意义（P＞0．05）。Ramsay评分：术后各时间点，A组均显著高于B组（P＜0．05）；恶心呕吐、躁动等并发症发生率，A组明显低于B组（P＜0．05）。结论后颅窝手术患者采用曲马多复合右美托咪定术后镇痛，可减少曲马多的用量，减少恶心呕吐、躁动等并发症的发生，同时镇痛效果理想，有利于术后病情的观察。
목적：탐토후로와수술환자곡마다복합우미탁미정술후진통감소곡마다용량적가행성。방법40례의행택기후로와수술적환자분위우미탁미정조（A조）화대조조（B조）。A조환자술후채용곡마다복합우미탁미정정맥빙입진통，감소곡마다용량；B조단용곡마다정맥빙입진통。관찰량조환자술전，술후1、6、12、24、48 h VAS평분、Ramsay평분、심솔、혈압、호흡빈솔、SpO2등생명체정변화급악심구토등술후병발증적발생정황，병진행통계학분석，평개량조환자술후진통진정적효과。결과VAS평분술후각시간점，조간차이무통계학의의（P＞0．05）。Ramsay평분：술후각시간점，A조균현저고우B조（P＜0．05）；악심구토、조동등병발증발생솔，A조명현저우B조（P＜0．05）。결론후로와수술환자채용곡마다복합우미탁미정술후진통，가감소곡마다적용량，감소악심구토、조동등병발증적발생，동시진통효과이상，유리우술후병정적관찰。
Objective To investigate the effects of posterior fossa operation analgesia with tramadol compound dexmedetomi‐dine ,and the feasibility of reducing the dosage of tramadol .Methods Forty cases undergoing posterior fossa operation were ran‐domly divided into dexmedetomidine group (group A) and control group (group B) .Patients in group A with tramadol compound dexmedetomidine intravenous infusion analgesia ,reducing the dosage of tramadol .Group B with tramadol intravenous infusion anal‐gesia .To observe two groups of patients with preoperative ,postoperative 1 ,6 ,12 ,24 ,48 hVAS score ,Ramsay score ,heart rate , blood pressure ,respiratory rate ,SpO2 ,the postoperative complications such as nausea and vomiting ,and carries on statistics analy‐sis ,the two groups of patients with postoperative analgesic and sedative effect evaluation .Results VAS score :postoperative at each time point ,there was no significant difference between groups (P>0 .05) .Ramsay score :after operation and postoperative at each time point ,the experimental group were significantly higher than those in the control group (P<0 .05);the incidence of nausea and vomiting ,restlessness complications ,the experimental group was significantly lower than that of the control group (P<0 .05) .Con‐clusion Posterior fossa operation patients with tramadol and dexmedetomidine postoperative to analgesia could reduce the dosage of tramadol ,reduce nausea and vomiting ,restlessness and other complications ,and the analgesic effect is ideal .It was favorable to ob‐serve the postoperative condition .