地佐辛复合舒芬太尼PCIA对经腹子宫切除术后患者睡眠质量的影响与安全

Effect of dizocine combined with sufentanil PCIA on sleep quality after abdominal hysterectomy and its safety

目的分析地佐辛复合舒芬太尼PCIA对经腹子宫切除术后患者睡眠质量的影响及安全性。方法将我院2018年6月至2019年6月收治择期行经腹子宫切除术的58例患者作为研究对象,采用随机数字表法分为两组,每组29例;SC组患者采用舒芬太尼自控镇痛,SD组患者采用地佐辛复合舒芬太尼自控镇痛。统计学分析比较两组患者的术中手术时间、麻醉时间、失血量、输液量等指标;并连接多导睡眠图监测仪连续3夜[当晚21:00至次日6:00,术前第1夜(T0),术后第1夜(T1),术后第2夜(T2)]对患者进行多导联睡眠功能检测,包括快速动眼睡眠、觉醒指数、睡眠效率、主观睡眠质量评分;记录患者术后6、24、48 h的VAS评分和镇静评分,同时记录舒芬太尼累积消耗量、患者术后48 h不良反应发生情况及患者满意度。结果T1、T2时点SD组觉醒指数显著低于SC组、睡眠效率及主观睡眠质量评分显著高于SC组(P<0.05);术后6、24、48 h VAS评分、舒芬太尼累积量SD组均显著低于SC组;全SD组术后6、24 h的镇静评分均明显高于SC组(P<0.05);患者满意度SD组(93.10%)显著高于SC组(72.41%)(P<0.05)。结论地佐辛复合舒芬太尼PCIA在经腹子宫切除术后应用,对提升患者的镇痛效果,促进睡眠质量,提升患者满意度均具有明显效果,值得临床推广。

Objective To explore the effect of dezocine combined with sufentanil PCIA on sleep quality of patients after abdominal hysterectomy and its safety.Methods A total of 58 patients who underwent elective abdominal hysterectomy from June 2018 to June 2019 in our hospital were selected as research object and divided into SC group(sufentanil alone to control analgesia)and SD group(dezocine combined with sufentanil to control analgesia)with 29 patients in each group.Intraoperative time,anesthesia time,blood loss,infusion volume and other indicators of the two groups were compared;the polysomnography monitor was connected for three consecutive nights(from 21:00 to 6:00 of the next day,the night before operation(T0),the first night after operation(T1),and the second night after operation(T2)to detect patients’polysomnography function,including rapid eye movement sleep,awakening index,sleep efficiency and subjective sleep quality score;the VAS score and sedation score of the patients 6,24 and 48 hours after operation were recorded.At the same time,the cumulative consumption of sufentanil,the incidence of adverse reaction 48 hours after operation and patient satisfaction were recorded.Results At T1 and T2,the arousal index of the SD group was significantly lower than that of the SC group,and the scores of sleep efficiency and subjective sleep quality were significantly higher;at 6,24,and 48 h postoperatively,the VAS score and the cumulative amount of sufentanil in the SD group were significantly lower than those in the SC group.The sedation scores 6 and 24 h after operation in the SD group were significantly higher than those in the SC group(P<0.05);patient satisfaction in the SD group(93.10%)was significantly higher than that in the SC group(72.41%)(P<0.05).Conclusion The application of dizocine and sufentanil PCIA after abdominal hysterectomy has significant effect on improving analgesic effect,sleep quality,and patient satisfaction,which is worth to be promoted.