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低剂量右美托咪定用于腹腔镜子宫切除术后静脉镇痛的临床观察 被引量:6

Clinical observation of low-dose dexmedetomidine for intravenous analgesia after laparoscopic hysterectomy
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摘要 目的 观察低剂量右美托咪定复合盐酸曲马朵用于腹腔镜子宫切除术后患者自控静脉镇痛(PCIA)的临床效果.方法 选择ASA Ⅰ~Ⅱ级36~ 65岁拟行腹腔镜子宫切除术的女性患者70例,采用随机数字表法将所有患者随机分为单纯曲马朵PCIA组(A组)、右美托咪定联合曲马朵PCIA组(B组),每组35例.采用视觉模拟评分(VAS)法比较两组术后24 h和48 h时段患者的疼痛评分;记录各时间段患者镇静评分、睡眠评分、盐酸曲马朵消耗量、哌替啶肌内注射次数及恶心呕吐、头晕、呼吸抑制等不良反应发生率.结果 两组VAS评分均小于4分.B组术后24、48 h等时间点的VAS评分(3.2±0.3)分、(2.7±0.3)分,均低于A组的(3.8±0.4)分、(3.2±0.2)分(t24=7.099,t48=8.204,均P<0.05).而两组镇静评分差异无统计学意义(P>0.05),且均小于1分,但B组睡眠评分(3.1±0.7)分,低于A组的(4.2±0.8)分(t=6.122,P<0.05).B组患者盐酸曲马朵消耗量[(625.2±113.7)mg]、哌替啶肌内注射次数(2.1±1.9)次,均小于A组[(782.9±102.6)mg,(5.2±2.2)次](t=6.092、6.309,均P<0.05).结论 低剂量右美托咪定可提高腹腔镜子宫切除术后盐酸曲马朵PCIA效果,并有助于减少盐酸曲马朵消耗量和不良反应发生率. Objective To observe the clinical effect of low-dose dexmedetomidine plus tramadol hydrochloride for patient-controlled interscalene analgesia (PCIA) after laparoscopic hysterectomy.Methods Seventy ASA Ⅰ ~ Ⅱ female patients with elective laparoscopic hysterectomy were randomly divided into two groups:the tramadol hydrochloride PCIA group(group A),and the dexmedetomidine plus tramadol hydrochloride PCIA group(group B),35 cases in each group.Visual analog scale (VAS),Ramsay scores,Sleepiness scale and the tramadol consumption were recorded.And the adverse events such as nausea and vomiting,dizziness and respiratory depression were observed.Results All patients got good analgesia in both two groups,VAS scores 〈 4.In group B,VAS scores of postoperative 24h and 48h were (3.2 ±0.3) (2.7 ±0.3),which were significantly lower than (3.8 ±0.4) and (3.2 ± 0.2) in group A (t24 =7.099,t48 =8.204,all P 〈 0.05).Sleepiness scale (3.1 ± 0.7) in group B was lower than group A (4.2 ± 0.8) (t =6.122,P 〈 0.05),while there was no difference of Ramsay scores between two groups (P 〉 0.05).And in group B,the tramadol consumption [(625.2 ± 113.7) mg] and the intramuscular pethidine times (2.1 ±1.9) were fewer than group A[(782.9 ± 102.6)mg,(5.2 ±2.2) times] (t =6.092,6.309,all P 〈0.05).Conclusion Low-dose dexmedetomidine may improve the effect of tramadol hydrochloride PCIA after laparoscopic hysterectomy,and help to reduce the tramadol consumption and adverse effects.
作者 闵卫翔
出处 《中国基层医药》 CAS 2014年第2期172-174,共3页 Chinese Journal of Primary Medicine and Pharmacy
关键词 镇痛 病人自控 右美托咪定 曲马朵 腹腔镜子宫切除术 Analgesia,patient-controlled Dexmedetomidine Tramadol Laparoscopic hysterectomy
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  • 1佘守章,许学兵,李慧玲,吴戴红,莫世湟.右旋美托咪啶的镇静效应及其对国人颈内动脉血流量的影响[J].广东医学,2005,26(6):729-732. 被引量:23
  • 2Riker RR, Shehabi Y, Paula M, et al. Dexmedetomidine vs midazolam for sedation of critically ill patients : a randomized trial. JAMA 2009,301 (5) :489-499.
  • 3Boyer J. Treating agitation with dexmedetomidine in the ICU. Dimens Crit Care Nurs,2009,28(3) :102-109.
  • 4Fagerholm V, Scheinin M, Haaparanta M. Alpha 2A-adrenoceptor antagonism increase insulin secretion and synergistically augments the insulinotropic effect of glibenclamide in mice. Br J Pharmacol,2008,154(6) :1287-1296.
  • 5Fagerholm V, Rokka J, Nyman L, et al. Autoradiographic characterization of alpha(2c) -adrenoceptors in the human striatum. Synapse,2008,62(7) :508-515.
  • 6Precedex TM Product Information. In: http//precedex. hospira. com/product information. aspx[25h August 2009].
  • 7Reade MC, O'Sullivan K, Bates S, et al. Dexmedetomidine vs haloperidol in delirium, agitated, intubated patients: a randomised open-label trial. Crit Care,2009,13(3) :R75.
  • 8Gerlach AT. Dexmedetomidine: an updated review. Ann Pharmacother,2007,41 (2) :245-253.
  • 9Ruokonen E, Parviainen I ,Jakob SM, et al. Dexmedetomidine versus propofol/midazolam for long-term sedation during mechanical ventilation. Intensive Care Med,2009,35 (2) :282-290.
  • 10Carollo DS, Nossaman BD, Ramadhyani U. Dexmedetomidine : a review of clinical applications. Curr Opin Anaesthesiol,2008,21(4) :457-461.

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  • 1陈晓燕.咪达唑仑与盐酸右美托咪定用于妇科手术麻醉镇静的疗效分析[J].医学信息(医学与计算机应用),2014,0(35):325-325. 被引量:3
  • 2周业建,李彦玮.不同麻醉方法对腹腔镜子宫切除术患者效果研究[J].医学信息(医学与计算机应用),2014,0(4):418-418. 被引量:3
  • 3乐杰.妇产科学[M].7版.北京:人民卫生出版社,2009:92-99.
  • 4Diniz MS, Teixeira-Neto FJ, Candido TD, et al. Effects of dexme-detomidine on pulse pressure variation changes induced by hem-orrhage followed by volume replacement in dogs [J]. J Vet Emerg Crit Care (San Antonio), 2014,24 (6):681-692.
  • 5Akkaya A,Tekelioglu UY,Demirhan A,et al. Comparison of the effects of magnesium sulphate and dexmedetomidine on surgical vision quality in endoscopic sinus surgery:randomized clinical study [J]. Rev Bras Anestesio1,2014 ,64 (6):406-412.
  • 6Kaur S, Attri JP, Kaur G, et al. Comparative evaluation of ropiva-caine versus dexmedetomidine and ropivacaine in epidural anes-thesia in lower limb orthopedic surgeries [J]. Saudi J Anaesth, 2014,8(4):463-469.
  • 7Wang HL, Tang SH, Wang XQ, et al. Doxapram hastens the recov-ery following total intravenous anesthesia with dexmedetomidine, propofol and remifentanil[J]. Exp Ther Med, 2015,9 (4):1518-1522.
  • 8Gupta K, Bansal M, Gupta PK, et al. Dexmedetomidine infusion during middle ear surgery under general anaesthesia to provide oligaemic surgical field:A prospective study [J]. Indian J An-aesth ,2015,59(1):26-30.
  • 9Izer JM, Whitcomb TL, Wilson RP. Atipamezole reverses ketamine-dexmedetomidine anesthesia without altering the antinociceptive effects of butorphanol and buprenorphine in female C57BL/6J mice [J]. J Am Assoc Lab Anita Sci,2014,53(6):675-683.
  • 10Thimmarayappa A, Chandrasekaran N, Jagadeesh AM, et al. Pedi-atric cardiac catheterization procedure with dexmedetomidine se-dation:radiographic airway patency assessment [J]. Ann Card An-aesth,2015,18(1):29-33.

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