右美托咪定复合低剂量舒芬太尼对老年患者全麻苏醒质量及术后疼痛的影响

Effect of Dexmedetomidine Combined with Low-dose Sufentanil on General Anesthesia Quality and Postoperative Pain in Elderly Patients

目的探讨右美托咪定复合低剂量舒芬太尼对老年患者全麻苏醒质量及术后疼痛的影响。方法方便选取该院2017—2018年这段期间内收治的行全麻开腹手术的老年患者60例作为临床研究对象,将之按照"随机对照分组法"分成2组:一组为右美托咪定组(30例),在术后采用右美托咪定镇痛;一组为复合组(30例),在术后采用右美托咪定复合低剂量舒芬太尼镇痛;观察比较两组患者的在拔管后10 min和拔管后30 min的MAP、HR、NRS评分等指标。结果复合组患者在拔管后10 min和拔管后30 min的MAP指标分别为(81.9±11.2)mmHg、(84.8±8.2)mmHg,右美托咪定组患者分别为(106.7±9.5)mmHg、(101.4±9.6)mmHg,复合组患者均显著低于右美托咪定组患者,差异有统计学意义(t=11.534、10.685,P<0.05);复合组患者在拔管后10 min和拔管后30 min的HR指标分别为(65.3±10.3)次/min、(67.0±10.2)次/min,右美托咪定组患者分别为(81.1±8.4)次/min、(76.9±11.5)次/min,复合组患者均显著低于右美托咪定组患者,差异有统计学意义(t=10.623,9.856,P<0.05);复合组患者在拔管后10 min和拔管后30 min的NRS评分分别为(2.2±0.6)分、(2.8±0.3)分,右美托咪定组患者分别为(3.9±0.8)分、(4.5±0.5)分,复合组患者均显著低于右美托咪定组患者,差异有统计学意义(t=5.621,6.120,P<0.05)。结论对老年全麻手术患者采用右美托咪定复合低剂量舒芬太尼进行术后镇痛的苏醒质量和镇痛效果显著,值得临床应用及推广。

Objective To investigate the effect of dexmedetomidine combined with low-dose sufentanil on the quality of general anesthesia and postoperative pain in elderly patients.Methods 60 elderly patients undergoing general anesthesia for open surgery during the period of 2017 to 2018 were convenient selected as clinical subjects.They were divided into two groups according to the "randomized control grouping method": one group was dexmedetomide group (30 cases),dexmedetomidine analgesia after operation;one group was combined group (30 cases),dexmedetomidine combined with low-dose sufentanil analgesia after operation;observation and comparison of the MAP,HR,NRS scores of the two groups of patients were 10 min after extubation and 30 min after extubation.Results The MAP indexes of the patients in the composite group at 10 min after extubation and 30 min after extubation were (81.9±11.2) mmHg and (84.8±8.2) mmHg,respectively,and those in the dexmedetomidine group were (106.7±9.5) mmHg,(101.4±9.6) mmHg,the patients in the composite group were significantly lower than the dexmedetomidine group,the difference was statistically significant (t=11.534,10.685,P<0.05);the patients in the composite group 10 minutes after extubation and after extubation HR indexes at 30 min were (65.3±10.3) times/min and (67.0±10.2) times/min,respectively,and those in the dexmedetomidine group were (81.1±8.4) times/min and (76.9±11.5) times/min,respectively.The patients in the composite group were significantly lower than those in the dexmedetomidine group (t=10.623,9.836,P<0.05).The NRS scores of the patients in the composite group 10 min after extubation and 30 min after extubation were respectively (2.2±0.6) points,(2.8±0.3) points,(3.9±0.8) points and (4.5±0.5) points in the dexmedetomidine group,respectively,the patients in the composite group were significantly lower than dexmedetomidine.The difference between the patients was statistically significant (t=15.621,6.120,P<0.05).Conclusion The effect of dexmedetomidine combined with low-dose sufentanil on postoperative analgesia in elderly patients undergoing general anesthesia is significant and worthy of clinical application and promotion.