基于VAS评价右美托咪定在宫颈癌根治术后镇痛及术后快速康复中的临床效果

Evaluation of clinical effect of dexmedetomidine on analgesia and rapid rehabilitation after radical operation for cervical cancer based on VAS

目的:研究右美托咪定在宫颈癌根治术后镇痛及术后快速康复中的临床应用效果。方法:将2015年7月至2018年7月在本院行宫颈癌根治术的86例患者随机分为对照组和观察组各43例。对照组术后镇痛采用舒芬太尼和格拉司琼,观察组术后镇痛加用右美托咪定。采用视觉模拟评分法(VAS)评价患者术后1 h、6 h、12 h、24 h、48 h疼痛情况,采用Ramesay评分法评价患者不同时间点镇静状况,记录并比较两组患者不同时间点收缩压、舒张压、心率及呼吸频率变化,比较两组患者不良反应发生情况。结果:观察组患者术后6 h、12 h、24 h、48 h VAS评分均明显低于对照组(P<0.05),Ramesay评分均明显高于对照组(P<0.05);观察组和对照组患者术后不同时间点呼吸频率比较,差异无统计学意义,但术后6 h、12 h、24 h观察组患者收缩压、心率均明显低于对照组(P<0.05),术后1 h、6 h观察组患者舒张压明显低于对照组(P<0.05);观察组患者恶心呕吐、高血压发生率较对照组明显减低。结论:右美托咪定用于宫颈癌根治术后镇痛,可以提高镇痛镇静效果,稳定患者血流动力学,有助于术后快速康复。

Objective:To study the clinical effect of dexmedetomidine in postoperative analgesia and postoperativerapid rehabilitation of radical operation for cervical cancer.Methods:86 patients who underwent radical operation for cervical cancer in our hospital from July 2015 to July 2018 were randomly divided into control group and observation group,with 43 cases in each group.The control group received sufentanil and granisetron for postoperative analgesia,and the observation group received dexmedetomidine for postoperative analgesia on the basis of the control group.Visual analogue scale(VAS)was used to evaluate the pain at 1 h,6 h,12 h,24 h and 48 h after operation,Ramesay score was used to evaluate the sedation status of patients at different time points.The changes of systolic blood pressure,diastolic blood pressure,heart rate,and respiratory rate at different time points were recorded and compared between the two groups.The incidence of adverse reactions was compared between the two groups.Results:The VAS score of the observation group at 6 h,12 h,24 h and 48 h after operation were significantly lower than those of the control group(P<0.05).Ramesay score was significantly higher than that of the control group(P<0.05).There was no significant difference in respiratory frequency between the observation group and the control group at different time points after operation,however,the systolic blood pressure and heart rate at 6 h,12 h and 24 h after operation were significantly lower than those in the control group(P<0.05).The diastolic blood pressure in the observation group was significantly lower than that in the control group at 1 h and 6 h after operation(P<0.05).The incidences of nausea,vomiting,and hypertension in the observation group were significantly lower than those in the control group.Conclusion:Dexmedetomidine in the analgesia after radical operation for cervical cancer can improve the analgesic and sedative effects,stabilize the hemodynamics of patients,and contribute to rapid recovery.