右美托咪定联合舒芬太尼对经腹子宫全切术后患者自控静脉镇痛的疗效观察

Observation on the Efficacy of Dexmedetomidine Combined with Sufentanil for Patient-con- trolled Intravenous Analgesia in Patients after Abdominal Hysterectomy

【目的】探讨右美托咪定联合舒芬太尼对经腹子宫全切术后患者自控静脉镇痛（PCIA）的疗效。【方法】采用随机数字表法将本院择期全身麻醉下行腹式子宫切除手术患者68例分为观察组和对照组，每组34例，分别给予不同药物组成的PCIA。观察组术后给予盐酸右关托咪定0．10μg／（kg·h）、舒芬太尼0．02μg／（kg·h）、托烷司琼5mg。对照组给予舒芬太尼O．04μg／（kg·h）、托烷司琼5mg。对比观察两组术后24h内总按压次数、舒芬太尼用量、不良反应发生情况，并记录术后2、4、6、8、12、24h各时间点的VAS和Ramsay评分。【结果】观察组24h内PCIA总按压次数和舒芬太尼用量明显少于对照组，且差异有显著性（P〈0．05）。观察组在术后4、8、12h时间点VAS评分明显低于对照组，而在术后24h内各时间点Ramsay镇静评分明显高于对照组，且差异均有显著性（P〈0．05）。观察组不良反应发生率明显低于对照组（P〈0．05）。【结论】右美托咪定联合舒芬太尼减少了舒芬太尼用量，明显提高了镇痛、镇静效果，减少了不良反应，其用于子宫全切术后患者PCIA优于单独应用舒芬太尼。

[Objective] To explore the efficacy of dexmedetomidine combined with sufentanil for patient- controlled intravenous analgesia（PCIA） in patients after abdominal hysterectomy. [MethodslSixty-eight pa- tients scheduled for abdominal hysterectomy under general anesthesia in our hospital were divided into observa- tion group and control group by using a random number table. The observation group received PCIA with hy- drochloric dexmedetomidine 0.10/~g/（kg ~ h）, sufentanil 0.02~g/（kg ~ h） and tropisetron 5rag. The control group received PCIA with sufentanil 0.04 ZHOU Qin （ Xiangya Hospital, Central South University, Changsha 410008, China ）g/（kg · h） and tropisetron 5rag. Total pressing times, sufentanil consumption and side effects in two groups within 24h after the operation were observed and compared. Visual analogue scale（VAS） and Ramsay sedation score at 2, 4, 6, 8, 12 and 24h after the operation were recorded. [Resultsl Total PCIA pressing times and sufentanil consumption in observation group within 24h were obvi- ously less than those in control group, and there was significant difference（ P〈0.05）. VAS score in observa- tion group at 4, 8 and 12h after the operation was obviously lower than that in control group, and Ramsay se- dation score in observation group at each time point within 24h after the operation was higher than that in con- trol group, and there was significant difference（ P d0.05）. The incidence of adverse reactions in observation group was obviously lower than that in control group（ P 〈0. 05）. [ConclusionlDexmedetomidine combined with sufentanil can reduce sufentanil consumption, and obviously significantly improve the analgesic and seda- tive effect, and decrease adverse reactions. Therefore it is better than sufentanil alone for patients after hyster- ectomy.