右旋美托咪啶用于UPPP术后镇痛镇静的临床观察

Clinical observationonthe patient-controlled analgesia of dexmedetomidine for obstructive sleep apnea syndrome patients post operation of UPPP

目的观察比较右旋美托咪啶以及芬太尼对阻塞性睡眠呼吸暂停综合征(OSAS)患者行悬雍垂腭咽成形术(UPPP)后留置气管导管的镇静镇痛效果。方法随机将33例行UPPP术后留置气管导管的患者分为芬太尼组(17例)和右旋美托咪啶组(16例)。比较两组患者疼痛视觉模拟评分法(VAS)评分、Prince-Henry评分和镇静评分,以及术后的安全性。结果两组患者术后6 h的VAS评分、Prince-Henry评分和镇静评分比较差异均无统计学意义(P>0.05);右旋美托咪啶组拔管前VAS评分、Prince-Henry和镇静评分均明显高于芬太尼组(P<0.05);右旋美托咪啶组患者均未发生恶心、呕吐症状,芬太尼组患者则有2例(12%);两组患者在术后均未发生严重的心血管事件,生命体征均平稳。结论右旋美托咪啶以及芬太尼均可用于UPPP后患者的镇痛镇静,前者不良反应少,但其镇痛效果不如后者,还有待提高。

Objective To compare the analgesia and sedation effect of dexmedetomidine and fentanyl for obstructive sleep apnea hyponea syndrome （OSAS） patients with endotracheal tub after uvulopalatopharyn- goplasty （UPPP）. Methods Twenty-four patients were divided into two groups randomly, dexmedetomidine group （n = 16 ） and fentanyl group （n = 17 ）. Score of Visnal analogue scale, Prince-Henry and Sedation were observedn. Results Score of VAS, Prince-Henry and Sedation had no differences at 6 h after operation be- tween the two groups. However analgesic effect in dexmedetomidine group were better than that those in fenta- nyl group before extubation. In dexmedetomidine group, none of the patients experienced nausea and vomiting, while two patients experienced that in fentanyl group. Serious cardiovascular events did not occur in the two groups. Vital signs of all the patients were stable. Conclusions The analgesia with dexmedetomidine and fentanyl can both gain satisfied effects. There was less adverse reaction for dexmedetomidiue. Of course, we should enhance analgesic effect of dexmedetomidine.