2017 年第 12 期 第 12 卷

右美托咪定超前镇痛在腰椎间盘突出症手术中的应用价值

作者：冉德伟

英文作者：

单位：100091北京，中国中医科学院西苑医院麻醉科

英文单位：

关键词：腰椎间盘突出症；右美托咪定；超前镇痛

英文关键词：

• 摘要：

• 目的    探讨右美托咪定超前镇痛在腰椎间盘突出症手术中的应用价值。方法    选取2013年1月至2016年12月在中国中医科学院西苑医院行腰椎间盘突出症手术的患者172例，根据随机信封抽签原则分为观察组与对照组，各86例。所有患者行全身麻醉下经皮套管腰椎椎旁入路手术治疗，对照组采用常规术后静脉注射镇痛，观察组在对照组基础上给予右美托咪定辅助超前镇痛。记录2组术后疼痛视觉模拟量表（VAS）评分、心率、呼吸频率变化，以及腰椎功能恢复情况。结果    所有患者均顺利完成手术，围术期无严重并发症发生。观察组术后2、24 h的VAS评分均明显低于对照组［（3.38±1.90）分比（4.48±2.31）分、（1.12±0.22）分比（2.18±0.38）分］，差异均有统计学意义(均P＜0.05)。2组术后2、4、24 h的心率与呼吸频率差异均无统计学意义(均P＞0.05)。观察组术后1、3个月的日本骨科学会评分均明显高于对照组［（78±11）分比（70±16）分、（86±11）分比（81±10）分］，差异均有统计学意义(均P＜0.05)。结论    右美托咪定超前镇痛应用于腰椎间盘突出症手术中能保持患者生命体征稳定，更加有效发挥镇痛作用，促进患者腰椎功能的恢复。

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  Value of dexmedetomidine preemptive analgesia in lumbar disc herniation operation

  Ran Dewei

  Department of Anesthesiology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing 100091, China, Email: dedede657@163.com

  【Abstract】Objective    To investigate the value of dexmedetomidine preemptive analgesia in lumbar disc herniation operation. Methods    Totally 172 patients who had lumbar disc herniation operation under general anesthesia from January 2013 to December 2016 in Xiyuan Hospital of China Academy of Chinese Medical Sciences were randomly divided into observation group and control group, with 86 cases in each group. The control group had conventional postoperative intravenous analgesia; the observation group had intravenous analgesia combined with dexmedetomidine preemptive analgesia. Postoperative score of the Visual Analogue Scale（VAS） for pain, changes of heart rate and respiratory rate and lumbar function recovery were analyzed. Results    The operation was successfully completed in all patients; no severe complication was observed. Postoperative 2, 24 h VAS scores in observation group were significantly lower than those in control group［（3.38±1.90）points vs （4.48±2.31）points, （1.12±0.22）points vs （2.18±0.38）points］（P＜0.05）. Postoperative 2, 4, 24 h heart rate and respiratory rate showed no significant differences between groups（P＞0.05）. Postoperative 1, 3-month Japanese Orthopaedics Association scores in observation group were significantly higher than those in control group［（78±11）points vs （70±16）points, （86±11）points vs （81±10）points］（P＜0.05）. Conclusion    Application of dexmedetomidine preemptive analgesia can maintain stable vital signs and exert effective analgesic effect, which promotes lumbar function recovery in patients with lumbar disc herniation operation.

  【Key words】Lumbar disc herniation;Dexmedetomidine;Preemptive analgesia