右美托咪定对肠梗阻术后患者止痛泵药物剂量及效果的影响

The effect of dexmedetomidine for the dosage of drug of pain pump ofthe patients postoperative

目的 探究右美托咪定对术后患者镇痛及止痛泵使用情况的影响。方法 选取2013年4月~2015年7月来浙江医院就诊的需行手术治疗的肠梗阻患者86例,依据抽签法将患者分为观察组和对照组,各43例。给予对照组术后常规止痛泵镇痛处理,观察组患者在对照组处理方案的基础上加用右美托咪定进行镇痛,观察比较两组患者心率、动脉收缩压（systolic arterial pressure,SAP）、动脉血氧分压（arterial partial pressure of oxygen,Pa O2）、镇痛满意度、视觉模拟评分法（visual analogue scale/score,VAS）疼痛评分、睡眠质量评分、舒芬太尼用量、自行给药次数、术后肛门排气时间及不良反应发生情况。结果 观察组治疗后36 h及72 h HR、SAP、Pa O2显著优于对照组（P〈0.05）;镇痛总满意度明显高于对照组（P〈0.05）;VAS疼痛评分显著低于对照组（P〈0.05）;睡眠质量评分明显高于对照组（P〈0.05）;、舒芬太尼用量及自行给药次数明显低于对照组（P〈0.05）;肛门排气时间明显短于对照组（P〈0.05）;不良反应发生率明显低于对照组（P〈0.05）。结论 应用右美托咪定可明显提高术后患者镇痛效果,减少止痛泵药物用量及其不良反应发生。

Objective To explore the effect of dexmedetomidine for the dosage of drug of pain pump of the patients postoperative. Methods F r o m April 2013 to July 2015,86 patients with intestinal obstructionwhich come to our hospital for surgical treatment were divided into observation group and control group according to the lottery method, each had 43 cases. The patients of control group were given pain pump for pain treatment ; a n d t h e patients of observation group were given dexmedetomidine on the base of control group for treatment. The heart rate, systolic arterial pressure （ SAP） , arterial oxygen pressure （Pa02） , analgesia satisfaction, visual analogue scale/score（ VAS） pain score, sleep quality score, sufentanil dosage, the number of self-administration ,adverse reactions, postoperative anal exhaust time. Results 3 6 h a n d 7 2 h, SAP, Pa02 in the o b s e r v a t i o n g r o u p w e r e significantly better than those in the control group after treatment （ P 〈 0. 05 ） ; The total satisfaction o f a n a l g e s i a w as significantly h i g h e r t h a n that of control g r o u p （P 〈0. 05） ; VAS pain score was significantly lower than the control group（P 〈0. 05） ; T h e s l e e p quality s c o r e w a s significantly h i g h e r t h a n that o f the control group （P 〈0. 05） ; The dosage of sufentanil and the times of administration were significantly lower than those of the control group （P 〈 0. 05 ）; Anal exhaust time was significantly shorter than the control group （P 〈0. 05） ; T h e i n c i d e n c e of a d v e r s e r e a c tions w a s significantly l o w e r t h a n that o f the control group （ P 〈 0. 05 ） . Conclusion By using dexmedetomidine on the base of pa i n pump can improve the analgesic effect p o s to p e r a t i v e,reduce the dosage of pain pump medication and the adverse reactions.