右美托咪定对全髋关节置换术患者术后睡眠及镇痛效果的影响

Effects of dexmedetomidine on postoperative sleep and analgesia in patients with total hip arthroplasty

目的:探讨右美托咪定对全髋关节置换术患者术后睡眠质量和镇痛效果的影响。方法:选择2020年5至10月在广西医科大学第一附属医院骨科行全髋关节置换术的患者60例,按随机数字表法将患者分为研究组(D组)和对照组(C组),每组30例。C组予常规麻醉,D组在此基础上术中泵注右美托咪定,并在手术结束前30 min停止泵注。比较两组患者术后尿中6-羟基硫酸褪黑素(6-HMS)浓度和阿森斯失眠量表(AIS)评分,术后静息和活动状态下视觉模拟疼痛(VAS)评分,术后24 h患者自控镇痛(PCA)用药量和有效按压次数。结果:与C组比较,D组术后1 d、2 d尿中6-HMS浓度显著升高,而术后1 d、2 d AIS评分,术后3 h、6 h、12 h、24 h、48 h静息VAS评分,术后3 h、6 h、12 h活动VAS评分显著降低,术后24 h有效按压次数和PCA用药量明显减少(均P<0.05)。结论:右美托咪定可有效改善全髋关节置换术患者术后睡眠质量,增强术后镇痛效果,值得临床推广应用。

Objective:To investigate the effects of dexmedetomidine on postoperative sleep quality and analgesia in patients with total hip arthroplasty.Methods:A total of 60 patients undergoing elective hip arthroplasty in orthopedics department from May 2020 to October 2020 were selected.The patients were randomly divided into study(D)group and control(C)group,30 patients in each group.Group C received routine anesthesia.On this basis,dexmedetomidine was injected intraoperatively in group D,and the pump was stopped 30 min before the end of the operation.The concentration of 6-hydroxymelatonin(6-HMS)in urine,Assens Insomnia Scale(AIS)score,visual analog pain(VAS)score in resting and active state,drug dosage and effective pressing times of patien-controlled analgesia(PCA)24 h after surgery were compared.Results:Compared with group C,6 HMS level was increasedon day 1 and 2 after operation,and AIS score on day 1 and 2,resting VAS scores at 3 h,6 h,12 h,24 h and 48 h,VAS score in active stateat 3 h,6 h and 12 h after surgery,drug dosage and effective pressing times of PCA 24 h after operation were decreased significantly(P<0.05).Conclusion:Dexmedetomidine can effectively improve the postoperative sleep quality of patients undergoing total hip replacement and enhance the postoperative analgesia effect,which is worthy of clinical promotion.