| Objective: by comparing the observed spray him with sheen compound right beautiful Joe mi and the right supporting mi on the application of the extraction of nucleus pulposus intervertebral foramen mirror effect and adverse reaction,clear spray him with sheen compound right beautiful mi in surgery of analgesic,sedative effect,adverse reaction and safety,to choose more appropriate anesthesia drugs used in the operation.Methods: A total of 60 patients who met the criteria were randomly divided into two groups according to the random number table according to the operation time sequence: group A(observation group),30 patients were treated with dexmedetomidine,and group B(control group),30 patients were treated with dexmedetomidine.All patients underwent strict preoperative fasting and fasting in accordance with the requirements of abstinence and fasting during elective surgery.30 minutes before the start of all patients were given scopolamine 0.3 mg intravenous injection,the patient into the operating room according to normal in 2 L/min flow after nasal catheter oxygen,open the upper extremity peripheral venous pathway,to compound salinger fluid to maintain,drip speed of 5ml/kg.(h),connecting the philips multifunctional monitor,giving patients routine operation monitoring: electrocardiogram(ECG)and heart rate(HR),noninvasive blood pressure(NBP),pulse oxygen saturation(SPO2),respiratory frequency(RR),and other indicators.After stable,turn over and lie on the stomach.After lying on the stomach,the two groups A and B were given dexmedetomidine intravenous infusion of 1 kg/kg,and the infusion was completed around 15 min.Then dexmedetomidine 0.5 kg/(kg·h)was pumped continuously with A micro pump until the end of the operation.At the beginning of disinfection,patients in group A were given A slow intravenous injection of tazocin 0.4mg/kg,with the time of intravenous injection of >10min.Patients in group B were given a slow intravenous infusion of 0.9% normal saline(NS)2ml at a time of >10min.Patients in groups A and B received local infiltration anesthesia with 1% lidocaine layer by layer before the operation,and the operation was performed after local infiltration anesthesia layer by layer by skin,subcutaneous tissue,muscle layer,deep fascia and facet joints.In the case of VAS>4 patients with rapid heart rate and high blood pressure,1ml of 1%lidocaine was added during the operation.Heart rate(HR),non-invasive blood pressure(NBP),pulse oxygen saturation(SPO2)and respiratory rate(RR)were recorded at the end of the operation(T5).Visual analogue VAS score and Ramsay score of pain at different time points of T0,T1,T2,T3,T4 and T5 were observed and evaluated.Record respiratory depression(SP02 in< 90%),low blood pressure,high blood pressure,agitation(defined as pain or discomfort in patients with body motion),bradycardia(HR < 50 times/min),tachycardia(HR > 110times/min)adverse conditions such as the number of cases,record the occurrence of postoperative shivering adverse reactions such as nausea,vomiting,bureau of anesthetic dosage.Results: there was no statistically significant difference in operation duration,weight and age between group A and group B(P > 0.05).Comparison of various life indicators at each time point in the operation between the two groups: compared with T0,the blood pressure in group A did not change significantly during the operation,while the heart rate decreased significantly at time point t1-t5(P < 0.05).At time point ti-t4,the heart rate and blood pressure in group B were all higher than T0(P < 0.05).Compared with group B,the blood pressure of group A was lower than that of group B at time point t1-t4,and the difference was statistically significant(P < 0.05).The heart rate of group A at time point t1-t5 was significantly lower than that of group B at time point,and the difference was statistically significant(P <0.05).The difference of oxygen saturation Sp O2 between the two groups at each time point was not statistically significant(P > 0.05).There was no statistically significant difference in RR between the two groups at each time point(P > 0.05).Comparison of ramsay sedation scores at each time point between the two groups: compared with T0 of the same group,the sedation scores at each time point were higher than T0(P <0.05).Compared with group B at the same time point,the ramsay sedation score of group A at each time point was between 2 and 3 points(3 points: patients responded toinstructions;2 points: patient coordination,directional force,quiet),good sedation effect,the difference was statistically significant(P < 0.05).Comparison of VAS pain scores at each time point between the two groups: compared with T0 of the same group,VAS scores at each time point were higher than T0(P < 0.05).Compared with the VAS score of group B,the VAS score of group A was lower than that of group B,that is,the analgesic effect of group A was better than that of group B,and the difference was statistically significant(P < 0.05).Comparison of adverse conditions of patients in the two groups:the number of patients in group A with adverse conditions such as hypertension,tachycardia and agitation during the operation was significantly lower than that in group B(P < 0.05),with statistically significant differences(see table 5).No anesthesia complications such as vomiting and nausea were found in the two groups.2.6 the total amount of local anesthetics used in the two groups was 7.9±1.8ml in group A and 11±1.5ml in control group B,with group B significantly higher than group A.Conclusion: the application of dexmedetomidine combined with tarzocine in the treatment of interforaminal endoscopic nucleus pulposus excision has good sedative and analgesic effects and less adverse reactions,which is safe and effective and worthy of clinical recommendation. |
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