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.
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