右美托咪定联合舒芬太尼用于术后镇痛对宫颈癌根治术患者心血管稳定性及VAS评分的影响

Influence of postoperative analgesia with dexmedetomidine combining sufentanil on cardiovascular stability and VAS score of patients treated with radical hysterectomy for cervical cancer

目的观察右美托咪定联合舒芬太尼用于术后镇痛对宫颈癌根治术患者心血管稳定性及VAS评分的影响。方法选取于2014年8月至2016年1月来济南军区总医院行宫颈癌根治术的宫颈癌患者64例,按照随机数表法将所有患者分为观察组和对照组,每组各32例。两组患者术后镇痛均使用舒芬太尼,其中观察组患者术后镇痛时加用右美托咪定。在术后1h、术后6h、术后12h、术后1d、术后2d时采用视觉模拟评分法(VAS)法对患者的疼痛程度进行对比分析,比较两组患者在各时间点心血管稳定性。结果术后1h、术后6h、术后12h、术后1d、术后2d时,观察组患者收缩压、舒张压、心率和呼吸频率均低于对照组。术后观察组患者术后1h、术后6h、术后12h、术后1d、术后2d各时间点舒张压明显低于对照组,差异有统计学意义(t值分别为4.86、4.48、6.75、4.70、5.46,均P<0.01)。术后观察组患者术后1h、术后6h、术后12h、术后1d、术后2d各时间点呼吸频率明显低于对照组,差异有统计学意义(t值分别为8.39、9.28、10.81、12.24、10.75,均P<0.01)。自术后6h起,术后12h、术后1d和术后2d时观察组患者收缩压明显低于对照组,差异有统计学意义(t值分别为3.40、3.94、5.07、2.94,均P<0.05)。术后1h时,对照组患者与观察组患者VAS评分比较差异无统计学意义(t=0.10,P>0.05)。术后6h、术后12h、术后1d、术后2d时对照组患者VAS评分明显高于观察组患者(t值分别为4.89、3.35、3.08、4.21,均P<0.01)。结论右美托咪定联合舒芬太尼用于宫颈癌根治术后患者镇痛比单用舒芬太尼镇痛的患者心血管稳定性和VAS评分更高。

Objective To observe the influence of postoperative analgesia with dexmedetomidine combining sufentanil on cardiovascular stability and VAS score of patients treated with radical hysterectomy for cervical cancer.Methods Altogether 64 cases of cervical cancer treated with radical hysterectomy for cervical cancer in Jinan Military General Hospital from August 2014 to January 2016 were selected and randomly divided into observation group and control group with 32 cases in each group.Patients in both groups were given sufentanil for postoperative analgesia.Patients in the observation group were also given dexmedetomidine.Pain degree of patients was compared with visual analogue scale （VAS） at 1h, 6h, 12h, 1d and 2d after operation,and cardiovascular stability in two groups were compared.Results Systolic blood pressure, diastolic pressure, heart rate and respiratory rate of patients in the observation group were lower than those in the control group at 1h, 6h, 12h, 1d and 2d after operation.Diastolic pressure of patients in the observation group at 1h, 6h, 12h, 1d and 2d after operation was significantly lower than that in the control group, and the difference was statistically significant （t value was 4.86, 4.48, 6.75, 4.70 and 5.46, respectively, all P〈0.01）.Respiratory rate of patients in the observation group at 1h, 6h, 12h, 1d and 2d after operation was significantly lower than that in the control group, and the difference was statistically significant （t value was 8.39, 9.28, 10.81, 12.24 and 10.75, respectively, all P〈0.01）.Since 6h after operation, systolic blood pressure in the observation group was significantly lower than that in the control group at 12h, 1d and 2d after operation （t value was 3.40, 3.94, 5.07 and 2.94, respectively, all P〈0.05）.At 1h after operation, there was no significant difference in VAS score between two groups （t=0.10, P〉0.05）.VAS score in the control group was significantly higher than that in the observation group at 6h, 12h, 1d and 2d after operation （t value was 4.89, 3.35, 3.08 and 4.21, respectively, all P〈0.01）.Conclusion Cardiovascular stability and VAS score of patients provided with dexmedetomidine and sufentanil for postoperative analgesia after radical hysterectomy for cervical cancer are better than those of patients given only sufentanil for postoperative analgesia.