右美托咪定复合舒芬太尼对普外科手术患者术后镇痛效果观察

Effect observation of dexmedetomidine combined with sufentanil on postoperative analgesia in patients undergoing general surgical surgeries

目的观察右美托咪啶复合舒芬太尼在普外科手术术后镇痛中的效果。方法选择ASAⅠ或Ⅱ级择期行普外科手术患者,随机均分3组:Ⅰ组为右美托咪定复合低剂量舒芬太尼组,Ⅱ组为低剂量舒芬太尼组,Ⅲ组为高剂量舒芬太尼组,每组25例。采用疼痛VAS评分评价3组术毕(T1)及术后不同时段疼痛程度及各时段自控镇痛按压次数,记录不良反应发生率。结果 3组术后各时点疼痛VAS评分均<4分,Ⅱ组术后各时段疼痛VAS评分显著高于Ⅰ、Ⅲ组(P<0.05);0～6、7～12、13～24hⅡ组自控按压次数明显多于Ⅰ、Ⅲ组(P<0.05)。Ⅲ组恶心呕吐发生率高于Ⅰ、Ⅱ组(P<0.05)。结论右美托咪定术后镇痛可减少舒芬太尼使用量,同时降低其恶心呕吐的发生率,具有良好的临床应用前景。

Objective To observe the effect of dexmedetomidine combined with sufentanil on postoperative analgesia in patients undergoing general surgical surgeries. Methods Seventy five patients with ASA physical status Ⅰ or Ⅱ undergoing elective general surgical surgeries were randomly divided into three groups, group Ⅱ was dexmedetomidine combined with sufentanil group, group Ⅱ was low dose sufentanil group, group Ⅲ was high dose sufentanil group. Pain intensity was as sessed with visual analog scale （VAS） at the immediate time after operation and different time points after operation. The number of patient-controlled press of the pump and the incidence of side effects were recorded. Results VAS scores of the three groups at all the time points were less than 4 scores, but pain intensity of group I1 after surgery was higher than that of the group I and Ill （P 〈 0.05）; and the number of self-controlled press of the pump in group ]I was markedly more than those of group I and 11I at 0-6 h, 7-12 h, 13-24 h （P 〈 0.05）. The incidence of nausea and vomiting in group Ⅲ was higher than those of group Ⅰ and Ⅱ （P 〈 0.05）. Conclusion Dexmedetomidine can reduce postoperative consumption of sufentanil in patients undergoing general surgical surgeries, and decrease the incidence of nausea and vomiting.