右美托咪定与瑞芬太尼对全麻腰椎板切除术后疼痛的影响比较

S. Sane, Rahman Abasi vash, Farzaneh Joshaghani, Gonash Alizadeh, B. Gholamveisi, Parang Golabi
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摘要

背景和目的:急性术后疼痛仍然是腰椎板切除术患者的一个问题。我们比较了瑞芬太尼和右美托咪定对脊柱手术患者疼痛强度和镇痛需求的影响。方法:选取60例年龄在20 ~ 60岁的美国麻醉协会ASA 1级和2级患者择期腰椎椎板切除术进行随机临床试验研究。患者分为瑞芬太尼(R组)和右美托咪定(D组)两组,R组患者麻醉诱导前使用0.01 می g / kg / min瑞芬太尼。D组采用注射泵按µg / min / 50kg注射0.3右美托咪定。记录术后疼痛评分、恶心、呕吐、平均动脉血压、恢复时间、术后6、12、24小时心率。结果:DEX组异丙酚输注率明显低于R组(P = 0.001)。除术后6h外,DEX组疼痛评分明显降低。DEX组镇痛药用量显著低于对照组(P=0.021)。DEX组术中、喉镜检查后平均动脉压及恢复时间均显著低于对照组(P<0.05)。DEX组喉镜检查后平均心率明显低于对照组(P=0.033)。结论:术中输注DEX可改善术中血流动力学参数,降低腰椎椎板切除术后疼痛评分和吗啡使用。
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Comparison of the effect of dexmedetomidine with remifentanil on pain after lumbar laminectomy in patients under general anesthesia
Backgrounds and objectives: Acute postoperative pain is still an issue in patients undergoing lumbar laminectomy surgery. We compared the effects of remifentanil and dexmedetomidine on pain intensity as well as the analgesic requirements in patients undergoing spinal surgery. Methods: This randomized clinical trial study was conducted on 60 patients in the age range of 20 to 60 years with ASA class one and two of the American Anesthesia Association under elective lumbar vertebrae laminectomy. Patients were divided into two groups: Remifentanil (group R) and Dexmedetomidine (group D). Before induction of anesthesia in R group patients, 0.01 می g / kg / min remifentanil was used. In group D, 0.3 dexmedetomidine was injected from µg / min / 50kg using a syringe pump. Postoperative pain score, nausea, and vomiting, mean arterial blood pressure, and heart rate at recovery times, 6, 12, and 24 hours after surgery were recorded. Results: The propofol infusion rate was significantly lower in the DEX group than in group R (P = 0.001). Pain scores except for 6h after surgery was significantly lower in group DEX. Analgesic consumption was significantly lower in group DEX (P=0.021). Mean arterial pressure during surgery, after laryngoscopy, and recovery was significantly lower in group DEX (P<0.05). The mean heart rate after laryngoscopy was significantly lower in group DEX (P=0.033). Conclusion: Intraoperative infusion of DEX improved hemodynamic parameters during surgery and decreased pain score, morphine use after lumbar laminectomy surgery.
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