右美托咪定注射液对甲状腺手术患者术后镇痛作用的影响

Effect of dexmedetomidine injection on analgesic in patients after thyroid surgery

目的观察右美托咪定注射液对甲状腺手术术后镇痛作用的临床疗效及安全性。方法将102例甲状腺肿瘤进行甲状腺手术的患者随机分为对照组与试验组,每组51例。2组患者均于手术切皮前给予舒芬太尼10μg+0.375%罗派卡因混合液20 m L,术后给予盐酸格拉司琼注射液5 mg,每日1次,静脉滴注。对照组术前给予咪达唑仑注射液0.03 mg·kg^(^(-1)),静脉泵注;试验组术前给予盐酸右美托咪定注射液1μg·kg^(^(-1)),静脉泵注。比较2组患者的临床疗效、血清人β内啡肽(β-EP)、白细胞介素-6(IL-6)、C-反应蛋白(CRP)水平及药物不良反应发生情况。结果治疗后,试验组和对照组的总有效率分别为92.16%(47/51例)和78.43%(40/51例),差异有统计学意义(P<0.05)。治疗后,对照组和试验组人β内啡肽分别为(268.47±29.58),(284.47±30.05)pg·L^(^(-1));CRP分别为(4.47±0.54),(4.07±0.42)mg·L^(^(-1)),差异均有统计学意义(均P<0.05)。试验组的药物不良反应有嗜睡、呼吸抑制、恶心呕吐,药物不良反应发生率为5.88%(3/51例);对照组的药物不良反应有瘙痒、呼吸抑制、嗜睡、恶心呕吐,药物不良反应发生率为11.76%(6/51例),差异无统计学意义(P>0.05)。结论右美托咪定注射液对甲状腺手术术后镇痛作用的临床疗效显著,且安全性高。

Objective To observe the clinical efficacy and safety of dexmedetomidine on analgesic effect in patients after thyroid surgery.Methods A total of 102 patients after thyroid surgery were divided into control group and treatment group,each group 51 cases.Patients in both groups were given thyroid operation.Patients in both groups were given sulfentanyl 10 μg ＋ 0.375% ropivacaine mixture 20 m L before operation,granisetron hydrochloride injection 5 mg by intravenous drip,once a day after operation.Control group was given midazolam hydrochloride injection 0.03 mg · kg-1by intravenous drip before operation.Treatment group was received dexmedetomidine hydrochloride injection 1 μg·kg-1by intravenous drip before operation.The clinical efficacy,β-endorphin（β-EP）,interleukin-6（IL-6）,C-reactive protein（CRP） and adverse drug reactions in two groups were observed.Results After treatment,total effective rates in treatment and control groups were 92.16%（47/51 cases） and 78.43%（40/51 cases）,with significant difference（P 〈 0.05）.After treatment,β-endorphin in control group and treatment group were（268.47 ± 29.58）,（284.47 ± 30.05） pg·L-1,CRP were（4.47 ± 0.54）,（4.07 ± 0.42） mg·L-1（P 〈 0.05）.The adverse drug reactions in treatment group were lethargy,respiratory depression,nausea and vomiting,the incidence of adverse drug reactions was 5.88%（3/51 cases）.The adverse drug reactions in control group were itching,respiratory depression,drowsiness,nausea and vomiting,the incidence of adverse drug reactions was 11.76%（6/51 cases,P 〉 0.05）.Conclusion The analgesic effect of dexmedetomidine after thyroid surgery is effective with high safety.