右美托咪定与复合舒芬太尼联用对腹腔镜下直肠癌根治术后静脉自控镇痛的疗效观察

Clinical Efficacy of Dexmedetomidine Combined with Sufentanil in PCIA after Laparoscopic Colorectal Cancer Radical Surgery

目的：评价右美托咪定与复合舒芬太尼联用对腹腔镜下直肠癌根治术后患者静脉自控镇痛（patient controlled intravenous analgesia,PCIA）的效果。方法：选择60例择期全麻下行腹腔镜下直肠癌根治术患者,ASA分级I-Ⅱ级;将其分为2组（每组30例）,A组为对照组,镇痛泵（0.9%氯化钠液100 mL＋舒芬太尼100μg）;B组为试验组,镇痛泵（0.9%氯化钠液100 mL＋舒芬太尼100μg＋右美托咪定400μg）;分别记录各组患者24 h舒芬太尼总用量,并取不同时间点视觉模拟评分（Visual analogue score,VAS）,以及分析术后并发症（恶心、呕吐等）的发生原因。结果：试验组在两组各时间点上的VAS评分为最低,且24 h舒芬太尼总用量为最少,术后并发症的发生明显低于对照组。结论：右美托咪定与复合舒芬太尼联用对静脉自控镇痛在腹腔镜下直肠癌根治术后的使用取得良好的镇痛和镇静效果,值得临床进一步考证与推广。

Objective： To evaluate the effect of dexmedetomidine combined with sufentanil in patient controlled intravenous analgesia（PCIA） after Laparoscopic colorectal cancer radical surgery. Methods： Sixty patients with ASA status Ⅰ-Ⅱ under general anesthesia for elective laparoscopic colorectal cancer resection were randomly divided into two groups, 30 cases in each group. Group A was the control group, analgesia pump： saline 100 ml＋sufentanil 100 μg;Group B was the test group, analgesia pump： saline 100 ml＋sufentanil 100 Ixg＋dexmedetomidine given 400 μg. Total amount of stlfentanil in 24 h of each group patients was recorded, VAS scores at different time points and postoperative complications（nausea, vomiting） occurring in each group of patients were recorded. Results： The VAS score in experimental group at each time point was the lowest. And the total amount of sufentanil during 24 h was the least, incidence of postoperative complications was significantly lower than that of the control group. Conclusion： The application of dexmedetomidine combined with sufentanil in PCIA after laparoscopic colorectal cancer radical surgery produced a good analgesic and sedative effects, which are worthy of further research and promotion.