右美托咪定复合羟考酮用于经腹子宫切除术后患者自控镇痛的临床观察

Effects of dexmedetomidine combined with oxycodone in postoperative patient controlled analgesia after hysterectomy

目的 探讨右美托咪定复合羟考酮用于经腹子宫切除术后患者自控镇痛的安全性和有效性.方法 择期开腹子宫切除术患者60例,随机分为两组,每组30例,术后均行静脉自控镇痛.A组采用羟考酮0.8 mg/kg,B组加用右美托咪定0.5 mg/kg,羟考酮减量至0.5 mg/kg,两组均加昂丹司琼8 mg.背景输注量2 ml/h,锁定时间15 min,自控给药量0.5 ml.记录术后VAS与BCS舒适度评分,以及不良反应.结果 B组术后24、48 h时VAS低于A组,差异有统计学意义;BCS评分两组比较B组各时点均高于A组,差异有统计学意义.A组患者恶心、呕吐的发生率高于B组.结论 两种方法均可用于妇科手术后自控镇痛,但右美托眯定复合羟考酮用于静脉自控镇痛效果更好、不良反应少、安全性高.

Objective To observe the clinical effect and safety of dexmedetomidine combined with oxycodone in postoperative patient controlled analgesia after hysterectomy.Methods Sixty patients with hysterectomy were randomly divided into two groups, 30 cases in each group.All the patients carried out self-controlled intravenous analgesia postoperatively.The patients in group A were pumped intravenously with oxycodone 0.8 mg/kg, group B with oxycodone 0.5 mg/kg plus dexmedetomidine 0.5 μg/kg;ondansetron 8 mg was added in both groups, background dose 2 ml/h, bolus 0.5 ml, lockout time 15 min.The postoperative VAS, BCS and the adverse reactions were observed.Results VAS was lower in group B than that in group A at 24 h, 48 h after operation.BCS was higher in group B than that in group A, which was statistically significant.The incidences of nausea and vomiting were seldom in group B.Conclusion The two methods can be used for postoperative analgesia after gynecological surgery, but dexmedetomidine combined with oxycodone is better than oxycodone only with seldom adverse reaction.