摘要
目的探讨右美托咪定复合丙泊酚全身麻醉在椎管减压、植骨融合术中的应用价值。方法将2018年5月至2019年5月义乌市中心医院行椎管减压、植骨融合术的腰椎管狭窄老年患者157例随机分为研究组和对照组,研究组80例,对照组77例,对照组用丙泊酚、咪唑安定、枸橼酸舒芬太尼、顺苯磺酸阿曲库铵诱导气管插管,术中用丙泊酚和盐酸瑞芬太尼维持麻醉;研究组在对照组的基础上添用右美托咪定诱导气管插管及术中维持麻醉,其余均同对照组。比较两组术后苏醒时间、定向力恢复时间、拔管时间,比较两组治疗前后视觉模拟评分法(VAS)、疼痛分级法(NRS)评分;检测两组治疗前后血清中白细胞介素6(IL-6)、白细胞介素10(IL-10)、C反应蛋白(CRP)及红细胞沉降率(ESR)水平,记录两组治疗期间不良反应。结果经治疗后,研究组VAS、NRS评分明显低于对照组(P<0.05),血清中IL-6、IL-10、CRP和ESR水平明显低于对照组(P<0.05);两组术后苏醒时间、定向力恢复时间差异无统计学意义(P>0.05),研究组术后拔管时间明显短于对照组(P<0.05);两组治疗期间不良反应发生率均较低,且差异无统计学意义(P>0.05)。结论右美托咪定复合丙泊酚全身麻醉能提高行椎管减压、植骨融合术的腰椎管狭窄患者的镇痛效果,降低炎性反应,且具有较高的用药安全性。
Objective To explore the application value of dexmedetomidine combined with propofol general anesthesia in spinal canal decompression and bone graft fusion.Methods A total of 157 elderly patients with lumbar spinal stenosis who underwent spinal decompression and bone graft fusion in Yiwu Central Hospital from May 2018 to May 2019 were randomly divided into study group and control group,with 80 cases in study group and 77 cases in control group.In the control group,tracheal intubation was induced with propofol,midazolam,sufentanil citrate and atracurium cisphenesulfonate,and anesthesia was maintained with propofol and remifentanil hydrochloride during operation.In the study group,on the basis of the control group,dexmedetomidine was added to induce endotracheal intubation and maintain anesthesia during the operation,and the rest were the same as the control group.The postoperative recovery time,orientation recovery time and extubation time were recorded and compared between the two groups.The Visual analogue scale(VAS)and pain grading(NRS)scores were recorded before and after treatment.The levels of serum interleukin-6(IL-6),interleukin-10(IL-10),C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR)were detected before and after treatment in the two groups,and adverse reactions were recorded during treatment in the two groups.Results After treatment,the scores of VAS and NRS in study group were significantly lower than those in control group(P<0.05),the levels of serum IL-6,IL-10,and CRP were significantly lower than those in control group(P<0.05),and level of ESR in peripheral blood was significantly lower than that in control group(P<0.05).There were no significant differences in postoperative recovery time and directional force recovery time between the two groups(P>0.05).The postoperative extubation time in study group was significantly shorter than that in control group(P<0.05).The incidence of adverse reactions during treatment in both group was low,and the difference was not statistically significant(P>0.05).Conclusion Dexmedetomidine combined with propofol general anesthesia can improve analgesic effect of LSS patients undergoing spinal canal decompression and bone graft fusion.It can reduce inflammatory reaction,promote postoperative recovery with high safety.
作者
吴颜丹
沈雅定
黄发斌
Wu Yandan;Shen Yading;Huang Fabin(Department of Anesthesiology,Yiwu Central Hospital,Yiwu 322000,China)
出处
《中国临床保健杂志》
CAS
2021年第1期93-96,共4页
Chinese Journal of Clinical Healthcare
关键词
椎管狭窄
减压术
外科
脊柱融合术
麻醉
全身
右美托咪啶
二异丙酚
Spinal stenosis
Decompression,surgical
Spinal fusion
Anesthesia,general
Dexmedetomidine
Propofol
