右美托咪定对开颅手术患者术中疼痛的影响

Effect of intraoperative dexmedetomidine on post-craniotomy pain

目的观察右美托咪定对开颅手术患者术中疼痛、止痛剂消耗和不良反应的影响。方法将80例七氟醚-芬太尼麻醉下进行颅骨切开术的患者随机分为2组。从手术开始直至皮肤缝合期间,观察组给予右美托咪定0.5 mg/(kg·h),对照组给予相同剂量的安慰剂。在麻醉苏醒室中静脉注射曲马多(0.5 mg/kg)直至患者麻醉评分≤4分。记录术后曲马多消耗量、镇静评分、术后呕吐评分(Postoperative nausea and vomiting scores,PONVs)和不良反应。结果两组患者性别比例、手术特点和镇静水平比较差异无统计学意义(P>0.05)。术后右美托咪定可降低曲马多消耗量及术后呕吐评分。观察组患者术后呕吐的发生率低于对照组(P<0.05)。结论术中静脉滴注右美托咪定可以有效缓解术后患者的疼痛,减少术后镇痛药用量,减轻曲马多致术后呕吐的症状。

Objective To observe the effect of dexmedetomidine on pain,analgesic consumption and adverse reaction in patients after craniotomy.Methods Eighty patients were randomly allocated into two equal groups to receive a continuous dexmedetomidine infusion of 0.5 mg/（kg·h）（DEX group） or placebo（control group） during operation.Intravenous tramadol 0.5 mg/kg had not been administered until the anesthesia sore≤4,Tramadol consumption,sedation scores,postoperative nausea and vomiting（PONV） scores,and other adverse reactions were recorded.Results There was no significant difference in demographic data,surgical characteristics and sedation levels between the two groups（P 〉 0.05）.Postoperative dexmedetomidine could reduce tramadol consumption and PONV scores（P 〈0.05）.The incidence of PONV in DEX group was lower than that of control group（P 〈0.05）.Conclusion Intraoperative dexmedetomidine infusion can relieve the degree of pain and analgesic consumption after craniotomy with low incidence of PONV induced by tramadol.