右美托咪定复合舒芬太尼镇痛联合腹横肌平面阻滞对经腹全子宫全切术患者早期康复的影响

Effect of Dexmedetomidine Combined with Sufentanil Analgesia Combined with Transverse Abdominal Plane Block on Early Rehabilitation of Patients Undergoing Total Abdominal Hysterectomy

目的:探讨右美托咪定复合舒芬太尼镇痛联合腹横肌平面阻滞(TAPB)对经腹全子宫全切术患者早期康复的影响。方法:选择2017年2月-2019年1月于本院就诊并拟行经腹子宫全切术的患者84例,采用随机数字表法将患者分为研究组与对照组,每组42例。两组患者均在超声引导下行TAPB,对照组患者予以舒芬太尼镇痛,研究组患者予以右美托咪定复合舒芬太尼镇痛,比较两组镇痛效果及早期康复情况。结果:研究组术后2、4、6、12、24、48 h时VAS评分均显著低于对照组,差异均有统计学意义(P<0.05)。研究组术后24、48、72 h的QOR-15评分均显著高于对照组,差异均有统计学意义(P<0.05)。研究组的自主呼吸恢复时间、定向力恢复时间、拔管时间、苏醒室停留时间、首次排气时间、进食时间、住院时间均显著短于对照组,差异均有统计学意义(P<0.05)。结论:右美托咪定复合舒芬太尼镇痛联合腹横肌平面阻滞可有效减轻经腹全子宫全切术患者的术后疼痛程度,提高患者早期恢复质量,效果良好,值得推荐。

Objective:To investigate the effect of Dexmedetomidine combined with Sufentanil analgesia combined with transverse abdominal plane block(TAPB)on the early rehabilitation of patients undergoing total abdominal hysterectomy.Method:A total of 84 patients who were admitted to our hospital from February 2017 to January 2019 and underwent total abdominal hysterectomy were selected.Patients were divided into study group and control group by random number table method,42 cases in each group.Patients in both groups underwent ultrasound-guided TAPB,patients in the control group were given Sufentanil for analgesia,patients in the study group were given Dexmedetomidine combined with Sufentanil for analgesia.The analgesic effect and early recovery of the two groups were compared.Result:VAS scores in the study group at 2,4,6,12,24 and 48 h after surgery were significantly lower than those in the control group,the differences were statistically significant(P<0.05).QOR-15 scores of the study group at 24,48 and 72 h after surgery were significantly higher than those of the control group,the differences were statistically significant(P<0.05).The recovery time of spontaneous breathing,recovery time of directional force,extubation time,stay time in awaking room,first exhaust time,feeding time and hospitalization time of the study group were significantly shorter than those of the control group,the differences were statistically significant(P<0.05).Conclusion:Dexmedetomidine combined with Sufentanil analgesia combined with TAPB can effectively reduce the postoperative pain level of patients undergoing total abdominal hysterectomy,improve the quality of patients’early recovery,and the effect is good,worthy of recommendation.