右美托咪定联合舒芬太尼对全麻腹部手术后的镇痛效果

Analgesic effect of dexmedetomidine combined with sufentanil on patients after abdominal operation under general anesthesia

目的观察右美托咪定联合舒芬太尼对全麻腹部手术患者的术后镇痛效果。方法将96例全麻下腹部手术患者随机分为观察组与对照组，各48例。对照组枸橼酸舒芬太尼1μg／（kg·d）、氢溴酸高乌甲素0．01mg／（kg·d）、雷莫司琼0．6mg加入生理盐水100ml，术毕静脉自控镇痛泵镇痛；观察组盐酸右美托咪定1．92μg／（kg·d）、枸橼酸舒芬太尼0．48μg／（kg·d）、雷莫司琼0．6mg加人生理盐水100ml，术毕静脉自控镇痛泵镇痛。首次负荷量1．5ml，之后1．5ml／h泵入，持续镇痛48h。结果T1、T2、T3、T4时点，观察组VAS评分及Ramesay镇静评分均明显低于对照组，差异有统计学意义（P〈0．05）；L时点，两组VAS评分及Ramesay镇静评分比较，差异无统计学意义（P〉0．05）；观察组术后不良反应发生率低于对照组，但差异无统计学意义（P〉0．05）。结论右美托咪定联合舒芬太尼用于全麻腹部手术后可明显提高镇痛、镇静效果，舒芬太尼用量明显减少，降低不良反应发生率。

Objective To observe the analgesic effect of dexmedetomidine combined with sufentanil on patients after abdominal operation under general anesthesia. Methods 96 patients taking abdominal operation under general anesthesia were divided into an observation group and a control group, 48 cases for each group. The control group mixed sufentanil citrate 1 μg/（kg d）, lappaconitine hydrobromide 0.01 mg/（ kg.d ） and 0.6 mg ramosetron with 100 ml normal saline; the pain was stopped through venous self-control analgesic pump after the operation. The observation group mixed dexmedetomidine hydroch 1.92 μg/（ kg＊d ） , sufentanil citrate 0.48 μg/（ kg d ） , and 0.6 mg ramosetron with 100 ml normal saline; the pain was stopped through venous self-control analgesic pump after the operation. The pumping capacity was 1.5 ml for the first time, then the capacity was 1.5 ml/h; the analgesia period was lasted for 48 h. Results At T1, T2, T3, and T4, the VAS score and Ramesay score were obviously lower in the observation group than in the control group, with statistical differences （P 〈 0.05）. At T5, there were no statistical differences in the VAS score and Ramesay score between these two groups （P 〉 0.05）. The incidence of postoperative adverse reactions was lower in the observation group than in the control group, but with no statistical difference （P 〉 0.05）. Conclusions Dexmedetomidine combined with sufentanil in abdominal operation can enhance the analgesic and sedative effect, reduce the usage of sufentanil, and decrease the incidence of adverse reactions.