右美托咪定复合舒芬太尼在小儿腹股沟区手术术后镇痛中的应用

The application of Dexmedetomidine combined with Sulfentanyl for postoperative analgesia in children's inguinal area

目的探究右美托咪定复合舒芬太尼在小儿腹股沟区手术术后镇痛中的应用价值。方法选择2016年6月~2017年6月承德市中医院和承德医学院附属医院收治的100例拟行小儿腹股沟区手术且需全身麻醉者作为研究对象,按照随机数字表法分为观察组(n=50)和对照组(n=50)。观察组采用右美托咪定复合舒芬太尼进行术后镇痛,对照组采用常规镇痛药进行术后镇痛。比较两组患儿术后不同时刻,即术后即刻(T_1)、术后2 h(T_2)、术后4 h(T_3)、术后8 h(T_4),两组患儿心率(HR)、平均动脉压(MAP)、镇静评分(Ramsay评分)、Wong-Baker面部表情量表评分及不良反应发生情况。结果两组患儿T2时刻HR、MAP均低于T1时刻,差异有统计学意义(P<0.05);而在T_1、T_2、T_3、T_4时刻,两组患儿HR、MAP比较,差异无统计学意义(P>0.05);两组患儿T_2、T_3、T_4时刻Ramsay评分均高于T_1时刻(P<0.05);观察组患儿T_2、T_3、T_4时刻Ramsay评分均高于对照组(P<0.05)。两组患儿T_2时刻WongBaker面部表情量表评分均高于T_1时刻,观察组患儿于T_2、T_3、T_4时刻Wong-Baker面部表情量表评分均低于对照组,差异均有统计学意义(P<0.05)。观察组患者不良反应发生率为14.00%,对照组不良反应发生率为10.00%,两组比较,差异无统计学意义(P>0.05)。结论小儿腹股沟区手术术后采用右美托咪定复合舒芬太尼具有较好的镇痛效果,对患儿血流动力学影响较小,安全性较高,值得临床推广。

Objective To explore the value of Dexmedetomidine combined with Sulfentanyl for postoperative analgesia in children＇s inguinal area.Methods From June 2016 to June 2017,100 cases of inguinal area operation and general anesthesia for children were studied in Chengde Hospital of Traditional Chinese Medicine and Affiliated Hospital of Chengde Medical University.According to the random number table method,they were randomly divided into observation group（n = 50,using Dexmedetomidine combined with Sulfentanyl for postoperative analgesia） and control group（n =50,conventional analgesics for postoperative analgesia）.HR,MAP,Ramsay score,Wong-Baker facial expression scale and adverse reactions were compared at different times after operation（i.e.T_1：immediately after operation;T_2：postoperative 2 h;T_3：postoperative 4 h;T_4：postoperative 8 h） between two groups.Results At T_2,HR and MAP of children in the two groups were lower than T_1,the differences were statistically significant（P〈0.05）,while in T_1,T_2,T_3 and T_4 time,there was no significant difference in HR and MAP between the two groups and the differences were not statistically significant（P 0.05）.The Ramsay scores at T_2,T_3 and T_4 in two groups were all higher than those at T_1,the scores at T_2,T_3 and T_4 in the observation group were higher than those in the control group（P 0.05）.At T_2,Wong-Baker facial expression scale scores of two groups were higher than those at T_1,Wong-Baker facial expression scale scores of the observation group at T_2,T_3,T_4 were lower than those of the control group,and the differences were all statistically significant（P 0.05）.The incidence of adverse reactions in the observation group was14.00%,and the incidence of adverse reactions in the control group was 10.00%.There was no statistical significant difference in the incidence of adverse reactions between the two groups（P 0.05）.Conclusion Dexmedetomidine combined with Sulfentanyl has good analgesic effect in children after inguinal surgery.It has little influence on hemodynamics and safety,and it is worthy of clinical application.