术后小剂量匀速输注右美托咪定对静脉自控镇痛效果及患者胃肠功能恢复的影响

Influence of low-dose constant-rate infusion of Dexmedetomidine after surgery on the effect of patient-controlled intravenous analgesia and recovery of gastrointestinal function

目的探讨术后小剂量匀速输注右美托咪定对妇科开腹手术患者静脉自控镇痛效果及胃肠功能恢复的影响。方法选取2019年1~10月于粤北人民医院接受开腹手术的60例妇科患者作为研究对象,根据随机双盲法分为S组(舒芬太尼组)和D组(右美托咪定组),每组各30例。两组患者术后镇痛药物配比均为舒芬太尼2μg/kg与100 ml生理盐水混合液。在开启镇痛泵的同时,D组小剂量匀速静脉滴注右美托咪定,S组匀速输入等量的生理盐水。比较两组患者术后4、8、12、24 h四个时间点生命体征、疼痛数字评分法(NRS)评分;48 h内镇痛泵按压次数、舒芬太尼的用量、胃肠功能恢复时间及其他不良反应的发生情况。结果 D组患者术后4、8、12、24 h四个时间点NRS评分均低于S组,差异有统计学意义(P<0.05);D组患者术后2 d内静脉自控镇痛按压次数和舒芬太尼总用量少于S组,胃肠功能恢复时间短于S组,差异有统计学意义(P<0.05)。D组患者的恶心呕吐发生率低于S组,差异有统计学意义(P<0.05)。结论术后小剂量匀速输注右美托咪定对妇科开腹手术患者可以减少静脉自控镇痛药物使用剂量,缩短患者胃肠功能恢复时间,并减少恶心呕吐的发生率,值得临床推广。

Objective To explore the influence of low-dose constant-rate infusion of Dexmedetomidine after surgery on the effect of patient-controlled intravenous analgesia(PCIA)and recovery of gastrointestinal function.Methods A total of 60 cases of gynecological patients who underwent laparoscopic surgery from January to October in 2019 in Yue Bei People′s Hospital were selected as the research objects,and were divided into group S(sufentanil group)and group D(dexmedetomidine group)according to the random double-blind method,30 cases in each group.While the analgesic pump was turned on,group D was given a small dose of Dexmedetomidine by intravenous infusion at a constant rate,and group S was given an equal amount of saline at a constant rate.Vital signs,pain digital score(NRS)scores at four time points of 4,8,12,and 24 hours postoperatively,the number of analgesic pump compressions within 48 hours,the amount of Sufentanil,and recovery of gastrointestinal function time and occurrence of other adverse reactions were compared between the two groups of patients.Results The NRS scores of patients in group D were lower than those in group S at 4,8,12,and 24 hours after surgery,and the differences were statistically significant(P<0.05).The number of intravenously controlled analgesic compressions and the total amount of Sufentanil in group D were less than those in group S within 2 days after surgery,and the recovery time of gastrointestinal function was shorter than that in group S,the differences were statistically significant(P<0.05).The incidence of nausea and vomiting in group D was lower than that in group S,the difference was statistically significant(P<0.05).Conclusion The low-dose constant-rate infusion of Dexmedetomidine after surgery can reduce the dose of intravenous self-controlled analgesic drugs,shorten the recovery time of gastrointestinal function,and reduce the incidence of nausea and vomiting in patients undergoing gynecological laparotomy.It is worthy of clinical promotion.