右美托咪定辅舒芬太尼用于全麻病人的术后镇痛

Dexmedetomidine hydrochloride assist sufentanil in postoperative analgesia for general anesthesia patients

目的评价右美托咪定联合舒芬太尼用于全麻病人术后镇痛镇痛效果及安全性。方法择期行腹部手术术后自愿行病人自控式镇痛的病人40例,随机分成两组,Ⅰ组为对照组,给予生理盐水+舒芬太尼+止吐药静脉自控镇痛泵;Ⅱ组为实验组,给予右美托咪定+舒芬太尼+止吐药静脉自控镇痛泵。观察两组患者术后48h内的血压(BP)、心率(HR)、脉搏氧饱和度(SpO2)、呼吸频率(RR)的变化情况、术后镇痛、镇静评分以及镇痛并发症的情况。结果血流动力学实验组较对照组更为平稳;术后2-8h内镇痛VAS评分比较,实验组明显优于对照组,镇静分级无差异;术后恶心、呕吐的发生率的比较,对照组明显多于实验组。结论对于全麻下行腹部手术的病人,右美托咪定辅助舒芬太尼用于术后镇痛与单纯应用舒芬太尼术后镇痛相比,患者术后的心血管稳定性较好,对术后镇痛的满意度高;且不良反应恶心呕吐明显减少,且在适当的药物剂量下呼吸抑制的发生率低。

Objective To assess the effect and safety of Dexmedetomidine hydroehloride with sufentanil in postoper- ative analgesia for general anesthesia patients. Methods Elect 40 cases of patients undergoing abdomial surgery and u- sing Patient-Controlled analgesia pumps voluntarily. The patients were randomly divided into two groups, the patients in group I received intravenous injection of Isotonic na chloride, sufentanil and antiemetic drugs through PCI, while in group Ⅱ the patients received intravenous injection dexmedetomidine, sufentanil and antiemetic drugs through PCI. Ob- serve the changes of blood pressure, heart rate, respiratory rate , SpO2, pain level, sedation scores and side effects in post-operation 48 hours. Results Hemodynamics in experimental group is more stable than the control group;Pain lev- els at rest group Ⅱ was better than group I during 2-8 hours after the operation;Sedation scores at rest had no signifi- cant difference;The incidence of nausea and vomiting of group I is less than that of the group Ⅱ. Conclusion For general anesthesia patients undergoing abdomial surgery , Compared with the simple application of sufentanil, dexme- detomidine assisting sufentanil for postoperative analgesia provides higher degree of cardiovascular stability and higher satisfaction to the abdominal surgery patients;and reduce the incidence of nausea and vomit, and lower the degree of re spiratory depression in the appropriate drug doses.