地佐辛＋舒芬太尼复合不同剂量右美托咪定在经腹子宫切除术中的应用效果

Application of Dezocine and Sufentanil Combined with Different Doses of Dexmedetomidine during Surgery in Abdominal Hysterectomy

[目的]探讨地佐辛＋舒芬太尼复合不同剂量右美托咪定在经腹子宫切除术中的应用效果。[方法]将160例行经腹子宫切除术患者随机分为4组，每组各40例，A组、B组、C组分别给予地佐辛＋舒芬太尼复合0．5μg／kg、1．0μg／kg、1．5μg／kg右美托咪定进行自控静脉镇痛，D组予地佐辛＋舒芬太尼进行自控静脉镇痛，比较4组术后1h（T1）、6h（T2）、12h（T3）、24h（T4）、48h（T5）疼痛程度（VAS）、舒适程度（BCS）、Ramsay评分及不良反应发生率。[结果]与A、D组比较，B组、C组T2、T3时刻VAS评分明显降低（P〈0．05），T3、T4、T5时刻BCS评分均明显升高（P〈0．05）；与C组比较，B组T3、T4时刻Ramsay评分均明显降低（P〈0．05）；A组、B组不良反应发生率均低于C组和D组（P〈0．05）。[结论]在经腹子宫切除术中，地佐辛＋舒芬太尼复合1．0μg／kg右美托咪定术后镇痛效果较好，不良反应少，且舒适度较高，值得临床重视。

[Objective]To investigate the application of dezocine and sufentanil combined with different do ses of dexmedetomidine in abdominal hysterectomy surgery. [Methods]A total of 160 cases after the abdomen womb excision surgery were divided into four groups, with 40 cases in each group. Group A, group B and group C were given dezocine and sufentanil combined with 0.5 μg/kg, 1.0 μg/kg and 1.5μg/kg dexmedetomi- dine ,respectively,and group D was only given dezocine and sufentanil. Degree of pain （VAS）, degree of comfort （BCS）, Ramsay sedation score and incidence of adverse reactions were compared postoperative lh （T1）, 6h （T2）, 12h （T3）, 24h （T4）, 48h （T5） amongst the four groups of patient-controlled intravenous analgesia （PCIA）. [Results]Compared with group A and D, the VAS scores at T2, T3 of group B and C were signifi- cantly decreased （ P 〈0.05） and the BCS score at T3, T4 , T5 were dramatically increased （ P〈0.05）. Compared to g T3, T4 , T5 moment BCS scores were significantly increased （ P 〈0.05）. Compared to group C, the Ramsay scores of group B at T3 and T4 were significantly decreased （ P〈0.05）. The incidence of adverse reactions in group A and group B were lower than those of group C and D （ P〈0.05）. [Conclusion] In abdominal hysterectomy, dezocine and sufentanil combined with 1.0 μg/kg dexmedetomidine postoperative analgesia has better effect, fewer adverse reactions, and more comfort： it is worth clinical attention.