摘要
目的观察右美托咪定联合舒芬太尼对胸科手术术后镇痛的效果。方法选择2014年3月至2015年3月于青岛市市立医院就诊的择期行胸科手术患者60例,完全随机分为舒芬太尼组和舒芬太尼联合右美托咪定组(联合组),各30例。患者自控静脉镇痛,舒芬太尼组采用舒芬太尼1.0μg/(kg·d),联合组采用舒芬太尼1.0μg/(kg·d)±右美托咪定1.0μg/(kg·d)。采用疼痛视觉模拟量表(VAS)评分评价2组患者术毕(T1)及术后2h(T2)、4h(T4)、6h(T4)、12h(T5)、24h(T5)与48h(T7)疼痛程度,比较2组患者术后自控镇痛按压次数,并记录不良反应发生情况。结果2组患者术后各时点VAS评分均〈4分,T,~B时点舒芬太尼组VAS评分明显高于联合组[(2.10±1.55)分比(0.86±0.80)分、(1.89±1.36)分比(0.75±0.48)分、(1.65±1.27)分比(0.68±0.57)分、(1.62±1.18)分比(0.50±0.39)分、(1.60±1.06)分比(0.47±0.31)分、(0.60±0.18)分比(0.00±0.00)分],差异均有统计学意义(均P〈0.05)。术后舒芬太尼组自控镇痛按压次数、舒芬太尼用量明显高于联合组[(16.0±2.8)次比(6.8±2.7)次,(86±10)Ixg比(68±7)峭],差异有统计学意义(P〈0.05)。2组患者均未发生呼吸抑制。舒芬太尼组恶心呕吐10例,未发生嗜睡和心动过缓;联合组嗜睡2例,心动过缓3例,未发生恶心呕吐。结论右美托咪定用于胸科手术术后镇痛可减少舒芬太尼用量,同时降低恶心呕吐发生率。
Objective To observe the effect of sufentanil combined with dexmedetomidine on postoperative analgesia in patients undergoing thoraeotomy surgeries. Methods Sixty patients undergoing elective gynecological laparoscopie surgeries from March 2014 to March 2015 were randomly divided into sufentanil group (30 cases) receiving patient controlled intravenous analgesia ( PCIA ) with sufentanil 1.0μg/( kg· d), combined group (30 cases) receiving PCIA with sufentanil 1. 0μg/(kg· d) ± dexmedetomidine 1.0 p.g/(kg ·d). The pain intensity was assessed with visual analog scale (VAS) immediately after operation ( T~ ) and 2 h ( T2 ), 4 h ( T3 ), 6 h ( T4 ) , 12 h ( T5 ) , 24 h ( T6 ) , 48 h ( T7 ) after operation. The number of self-controlled press of the pump and incidence of side effects were recorded. Results The VAS score at all the time points were less than 4 scores in both groups; at T2-T7 time point, the VAS score in sufentanil group was significantly higher than that in combined group E(2- 10 ± 1.55) scores vs (0. 86 ±0. 80) scores, (1. 89 ± 1. 36) scores vs (0. 75 ± 0.48) scores, ( 1.65 ± 1.27) scores vs (0.68 ± 0.57) scores, ( 1.62± 1.18 ) scores vs (0.50 ± 0.39) scores, ( 1.60 ± 1.06) scores vs (0.47 =l: 0.31 ) scores, (0.60 ± 0.18 ) scores vs (0. O0± 0.00) scores ] ( P 〈 O. 05 ). At T2-T7 time point, the number of self-controlled press of the pump in sufentanil group was significant].y more than that in combined group [ ( 16.0 ± 2.8 ) times vs (6.8 ±2.7 ) times, ( 86 ± 10) μg vs (68 ± 7 )μg] ( P 〈 0. 05 ). The incidence of nausea and vomiting in sufentanil group was significantly higher than that in combined group [ 33.3% ( 10/30 ) vs 0.0% ( 0/30 ) ] ( P 〈 0.05 ). Conclusion Dexmedetomidine can reduce the postoperative consumption of sufentanil in patients undergoing thoracotomy surgeries, and decrease the incidence of nausea and vomiting.
出处
《中国医药》
2016年第6期861-864,共4页
China Medicine
关键词
胸科手术
舒芬太尼
右美托咪定
术后镇痛
Thoracotomy surgery
Sufentanil
Dexmedetomidine
Postoperative analgesia