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不同镇痛方法对行急诊手术的中重度颅脑损伤患者围术期疼痛的临床研究。

Clinical research of different analgesia methods on perianesthetic pain of patients with moderate and severe craniocerebral injury who have emergency operation.

机构信息

Department of Anesthesiology, Shanxian Central Hospital, Shanxian, Shandong, China.

出版信息

Eur Rev Med Pharmacol Sci. 2017 Jul;21(3 Suppl):88-92.

Abstract

OBJECTIVE

To compare the effects of two different analgesia methods on postoperative pain of patients with moderate and severe craniocerebral injury who had an emergency operation.

PATIENTS AND METHODS

In this study, 64 patients who were treated in our hospital from January 2015 to January 2016 and diagnosed with acute craniocerebral injury, were consecutively selected. The patients were divided into the propofol total intravenous anesthesia group (the observation group) and the isoflurane intravenous-inhalation combined anesthesia group (the control group) randomly with 32 cases each. Mean arterial pressure (MAP), partial pressure of oxygen (SpO2), and heart rate (HR) were compared and analyzed before and after anesthesia. At the first, second, and third day after the operation, adopt visual analogue scale (VAS), and sedation-agitation scale (GCS) were used to evaluate sedative and analgesic effects of patients.

RESULTS

After anesthesia had succeeded, HR, SpO2, and MAP of patients in these two groups decreased, but the decrease in the observation group was less than that in the control group. The differences had statistical differences (p<0.05). At the first, second, and third day after the operation, scores of VAS and GCS in the observation group were obviously lower than those in the control group, and the differences had statistical differences (p<0.05). The total effective rate of anesthesia in the observation group was higher than that in the control group, and the differences had statistical differences (p<0.05).

CONCLUSIONS

For patients with moderate and severe craniocerebral injury who had an emergency operation, propofol total intravenous anesthesia is more stable and has a better postoperative pain comparing with isoflurane intravenous-inhalation combined anesthesia.

摘要

目的

比较两种不同镇痛方法对行急诊手术的中重度颅脑损伤患者术后疼痛的影响。

方法

选取 2015 年 1 月至 2016 年 1 月在我院治疗的中重度颅脑损伤患者 64 例,连续纳入,随机分为丙泊酚全凭静脉麻醉组(观察组)和异氟醚静吸复合麻醉组(对照组),每组 32 例。比较分析麻醉前后平均动脉压(MAP)、氧分压(SpO2)、心率(HR)。术后第 1、2、3 天采用视觉模拟评分法(VAS)、镇静躁动评分(GCS)评估患者镇静镇痛效果。

结果

麻醉成功后,两组患者 HR、SpO2、MAP 均降低,但观察组降低幅度小于对照组,差异有统计学意义(p<0.05)。术后第 1、2、3 天,观察组 VAS、GCS 评分明显低于对照组,差异有统计学意义(p<0.05)。观察组麻醉总有效率高于对照组,差异有统计学意义(p<0.05)。

结论

对行急诊手术的中重度颅脑损伤患者,丙泊酚全凭静脉麻醉较异氟醚静吸复合麻醉更平稳,术后疼痛改善更明显。

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