右美托咪定联合舒芬太尼在骨科手术后镇痛中的效果

Effect of dexmedetomidine combined with sufentanil on postoperative analgesia for patients with orthopedic surgery

目的评估右美托咪定联合舒芬太尼在骨科手术术后镇痛中的效果。方法选择行骨科手术的患者86例,随机分为观察组和对照组。观察组采用右美托咪定联合舒芬太尼术后镇痛,对照组采用舒芬太尼术后镇痛。采用疼痛视觉模拟量表(VAS)和定量感觉测试(QST)评价2组患者不同时间点的疼痛程度,比较2组患者术后自控镇痛按压的次数、血流动力学参数、不良反应发生率和满意率。结果对照组T_1~T_6时VAS评分显著高于观察组,机械性疼痛阈值显著低于观察组,HR和MAP显著高于观察组(P<0.05)。对照组自控镇痛按压次数、舒芬太尼用量以及不良反应发生率显著高于观察组(P<0.05)。观察组满意率显著高于对照组(P<0.05)。结论右美托咪定用于骨科手术术后镇痛可减少舒芬太尼用量,降低不良反应发生率。

Objective To evaluate the effect of dexmedetomidine combined with sufentanil on postoperative analgesia for patients with orthopedic surgery. Methods A total of 86 patients with orthopedic surgery were randomly divided into observation group and control group. The patients in the observation group were treated with dexmedetomidine combined with sufentanil for postoperative analgesia. The control group was treated with sufentanil for postoperative analgesia. The VAS and quantitative sensory testing （QST） were performed at different time points in both groups. The number of postoperative patient-controlled analgesia, hemodynamics parameters, the adverse reaction and satisfaction degree were compared between the two groups. Results The VAS scores at T1 to T6 in control group were significantly higher than the observation group, the mechanical pain threshold was significantly lower than the observation group, and the HR and MAP were significantly higher than the observation group （P 〈 0.05 ）. The number of patient-controlled analgesia, the dosage of sufentanil and the incidence rate of adverse reactions were significantly higher in the control group than the observation group （ P 〈 0.05）. The satisfactory degree of the observation group was significantly higher than the control group （P 〈 0.05）. Conclusion Dexmedetomidine can reduce the dosage of sufentanil and the incidence rate of side effects in treatment of patients with orthopedic surgery.