曲马多复合右美托咪定用于后颅窝手术术后镇痛效果观察

目的：探讨后颅窝手术患者曲马多复合右美托咪定术后镇痛减少曲马多用量的可行性。方法40例拟行择期后颅窝手术的患者分为右美托咪定组（A组）和对照组（B组）。A组患者术后采用曲马多复合右美托咪定静脉泵入镇痛，减少曲马多用量；B组单用曲马多静脉泵入镇痛。观察两组患者术前，术后1、6、12、24、48 h VAS评分、Ramsay评分、心率、血压、呼吸频率、SpO2等生命体征变化及恶心呕吐等术后并发症的发生情况，并进行统计学分析，评价两组患者术后镇痛镇静的效果。结果VAS评分术后各时间点，组间差异无统计学意义（P＞0．05）。Ramsay评分：术后各时间点，A组均显著高于B组（P＜0．05）；恶心呕吐、躁动等并发症发生率，A组明显低于B组（P＜0．05）。结论后颅窝手术患者采用曲马多复合右美托咪定术后镇痛，可减少曲马多的用量，减少恶心呕吐、躁动等并发症的发生，同时镇痛效果理想，有利于术后病情的观察。

Observation of the effect of posterior fossa operation analgesia with tramadol compound dexmedetomidine

Objective To investigate the effects of posterior fossa operation analgesia with tramadol compound dexmedetomi‐dine ,and the feasibility of reducing the dosage of tramadol .Methods Forty cases undergoing posterior fossa operation were ran‐domly divided into dexmedetomidine group (group A) and control group (group B) .Patients in group A with tramadol compound dexmedetomidine intravenous infusion analgesia ,reducing the dosage of tramadol .Group B with tramadol intravenous infusion anal‐gesia .To observe two groups of patients with preoperative ,postoperative 1 ,6 ,12 ,24 ,48 hVAS score ,Ramsay score ,heart rate , blood pressure ,respiratory rate ,SpO2 ,the postoperative complications such as nausea and vomiting ,and carries on statistics analy‐sis ,the two groups of patients with postoperative analgesic and sedative effect evaluation .Results VAS score :postoperative at each time point ,there was no significant difference between groups (P>0 .05) .Ramsay score :after operation and postoperative at each time point ,the experimental group were significantly higher than those in the control group (P<0 .05);the incidence of nausea and vomiting ,restlessness complications ,the experimental group was significantly lower than that of the control group (P<0 .05) .Con‐clusion Posterior fossa operation patients with tramadol and dexmedetomidine postoperative to analgesia could reduce the dosage of tramadol ,reduce nausea and vomiting ,restlessness and other complications ,and the analgesic effect is ideal .It was favorable to ob‐serve the postoperative condition .