摘要
目的 探讨地佐辛联合右旋美托咪定在青少年斜视矫正术中的镇痛麻醉效果.方法 选取2014年11月至2016年7月青少年斜视患者86例,通过随机数字表法分组,每组43例.对照组静脉输注氯化钠注射液,研究组静脉注射地佐辛＋右旋美托咪定.对比手术前后两组抑郁评分（SDS）焦虑评分（SAS）和围术期[术前（t1）、术中（t2）、术后即刻（t3）、术后2 h（t4）、术后6 h（t5）]平均动脉压（MAP）、心率（HR）水平及疼痛评分（VAS）变化情况,统计对比两组麻醉镇静效果及不良反应发生率.结果 ①抑郁及焦虑状态：术前两组SAS评分及SDS评分比较差异未见统计学意义（P〉0.05）;术后两组SAS评分及SDS评分均较术前降低,且研究组各指标评分均低于对照组,差异有统计学意义（P〈0.05）.②围术期平均动脉压、心率及疼痛程度：t1时两组MAP、HR及VAS评分比较差异未见统计学意义（P〉0.05）,t2~t4时研究组VAS评分低于对照组,差异有统计学意义（P〈0.05）;t2时研究组HR水平明显降低,与对照组比较差异有统计学意义（P〈0.05）;t3~t5时两组HR水平比较差异未见统计学意义（P〉0.05）;各时间点两组MAP水平比较差异未见统计学意义（P〉0.05）.③镇静效果：研究组术中镇静程度均为2~3级,对照组均为1级.④不良反应：研究组不良反应发生率（18.61%）低于对照组（41.87%）,差异有统计学意义（P〈0.05）.结论 青少年斜视矫正术中联合应用地佐辛及右旋美托咪定可取得良好镇痛麻醉效果,利于患者术中配合医师操作,且有助于缓解疼痛感及不良心理状态,安全性较高,具有推广价值.
Objective To investigate the anesthesia effect of dezocine combined with dexmedetomidine on adolescent strabismus surgery.Methods A total of 86 adolescent strabismus patients from November 2014 to July 2016 were divided into two groups according to random number table, with 43 cases in each group.The control group was treated with intravenous infusion of sodium chloride injection, the study group was treated with intravenous dezocine and dexmedetomidine.Before and after surgery, depression scores（SDS）, anxiety scores （SAS） and perioperative [preoperative （T1）, during surgery （T2）, immediately after operation （T3）, 2 h after operation （T4）, 6 h after operative （T5）] mean arterial pressure （MAP）, heart rate （HR） and the levels of pain score （VAS） changes, and the incidences of adverse reactions were compared between the two groups.Results ① Depression and anxiety： there was no significant difference in the SAS score or SDS score between the two groups （P〉0.05）.The SAS scores and SDS scores of the two groups all decreased after operation, and the indexes of the study group were lower than those of the control group, the differences were significant （P〈0.05）.②There was no significant difference in MAP, HR or VAS score at t1 between the two groups（P〉0.05）;VAS in study group was lower at t2-t4 than that in control group, the difference was significant（P〈0.05）.The HR level in the study group at t2 was significantly lower than that in the control group, and the difference was significant（P〈0.05）.There was no significant difference in the level of HR at t3-t5 between the two groups （P〉0.05）.There was no significant difference in MAP levels between the two groups at different time points （P〉0.05）.③Sedative effect： the level of sedation in the study group was grade 2 to 3, and that in the control group was grade 1.④Adverse reactions： the incidence of adverse reactions in the study group （18.61%） was lower than that in the control group （41.87%）, and the difference was significant（P〈0.05）.Conclusions Dezocine and dexmedetomidine has good analgesic effect in the anesthesia of adolescent strabismus, which can help to relieve the pain and poor psychological state, with high safety, and has the value of popularization.
出处
《中国实用医刊》
2017年第15期73-77,共5页
Chinese Journal of Practical Medicine
