本文關(guān)鍵詞： 羥考酮 舒芬太尼 三叉神經(jīng)痛 微血管減壓術(shù)　出處：《臨床麻醉學(xué)雜志》2017年05期 　論文類型：期刊論文

【摘要】：目的評(píng)價(jià)羥考酮在三叉神經(jīng)微血管減壓術(shù)患者中應(yīng)用的安全性和有效性,并比較羥考酮與舒芬太尼對(duì)三叉神經(jīng)微血管減壓術(shù)患者術(shù)后早期恢復(fù)質(zhì)量的影響。方法選擇擇期行三叉神經(jīng)微血管減壓術(shù)患者86例,男38例,女48例,年齡18~65歲,BMI 18~30kg/m2,ASAⅠ或Ⅱ級(jí)。采用隨機(jī)數(shù)字表法將其分為兩組:羥考酮組(O組)和舒芬太尼組(S組),每組43例。兩組均接受靜-吸復(fù)合麻醉,麻醉誘導(dǎo)時(shí)O組靜脈注射羥考酮0.3mg/kg,S組靜脈注射舒芬太尼0.4μg/kg,在手術(shù)進(jìn)行到關(guān)硬膜后即刻,O組靜脈注射羥考酮0.07mg/kg,S組靜脈注射舒芬太尼0.1μg/kg。于術(shù)前1d、術(shù)后4、24和48h采用數(shù)字評(píng)分法(numeric rating scale,NRS)評(píng)估患者手術(shù)切口疼痛和三叉神經(jīng)區(qū)面部疼痛程度。當(dāng)NRS評(píng)分≥4分時(shí)O組靜脈注射羥考酮3mg,S組靜脈注射舒芬太尼5μg進(jìn)行補(bǔ)救鎮(zhèn)痛。于術(shù)前1d和術(shù)后3d采用40項(xiàng)恢復(fù)質(zhì)量評(píng)分量表(QoR-40量表)評(píng)估患者恢復(fù)質(zhì)量。記錄術(shù)后補(bǔ)救鎮(zhèn)痛情況、拔管時(shí)間、出院時(shí)間以及術(shù)后惡心嘔吐、心動(dòng)過緩、排尿困難、頭暈和瘙癢的發(fā)生情況。結(jié)果 O組術(shù)后3d的QoR-40量表評(píng)分中身體舒適度評(píng)分、情緒狀態(tài)評(píng)分、心理支持評(píng)分、疼痛評(píng)分及總評(píng)分明顯高于S組(P0.05)。O組術(shù)后惡心嘔吐發(fā)生率明顯低于S組(20.9%vs 37.2%)(P0.05)。結(jié)論在手術(shù)時(shí)間短于5h的三叉神經(jīng)微血管減壓術(shù)患者中,羥考酮0.3mg/kg可安全用于其麻醉誘導(dǎo),羥考酮0.07mg/kg及3mg可分別安全有效地用于其預(yù)防性鎮(zhèn)痛及補(bǔ)救鎮(zhèn)痛;與舒芬太尼比較,羥考酮可提高三叉神經(jīng)微血管減壓術(shù)患者術(shù)后早期恢復(fù)質(zhì)量,減少術(shù)后惡心嘔吐。
[Abstract]:Objective to evaluate the safety and efficacy of hydroxycodone in trigeminal microvascular decompression. To compare the effect of hydroxycodone and sufentanil on the quality of early recovery after microvascular decompression of trigeminal nerve, 86 patients (38 males and 48 females) underwent selective microvascular decompression of trigeminal nerve. The patients were divided into two groups by random digital table method: hydroxone group (O group) and sufentanil group (S group, 43 cases in each group). The two groups received combined intravenous anesthesia and inhaling anesthesia, and the two groups were divided into two groups: hydrocodone group (n = 43) and sufentanil group (n = 43). During anesthesia induction, O group was injected with hydroxycodone 0.3 mg 路kg ~ (-1) 路kg ~ (-1) by intravenous sufentanil 0.4 渭 g 路kg ~ (-1) 路kg ~ (-1). Immediately after operation, O group was given 0.07 mg 路kg ~ (-1) 路kg ~ (-1) of hydroxy codon and 0.1 渭 g / kg 路kg ~ (g / kg) of sufentanil. At 1 day before operation, 424 and 48 hours after operation, the patients in group O were given digital injection of sufentanil (0.1 渭 g / kg). Rating scaleNRS was used to evaluate the degree of surgical incision pain and facial pain in trigeminal nerve area. When NRS score was 鈮，

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