比较右美托咪定与纳布啡分别用于腹腔镜下全子宫切除术后镇痛镇静的效果

Comparison of the Effects of Dexmedetomidine and Nalbuphine for Analgesia and Sedation after Laparoscopic Hysterectomy

目的比较右美托咪定与纳布啡分别用于腹腔镜下全子宫切除术后镇痛镇静的效果。方法选取2017年1月-2020年3月接受腹腔镜下全子宫切除术治疗的患者102例,按照随机数字表法,分为对照组与观察组,各51例。对照组应用右美托咪定,观察组应用纳布啡,比较两组术后Ramsay镇静评分、视觉模拟评分法(VAS)评分与不良反应发生情况。结果相较于对照组的Ramsay镇静评分,观察组术后8 h[(4.18±0.33)分vs(3.65±0.35)分]、12 h[(3.56±0.30)分vs(2.70±0.28)分]、24 h[(2.80±0.32)分vs(2.55±0.25)分]均更高,差异有统计学意义(t=7.868、14.966、4.397,P<0.05);相较于对照组的VAS评分,观察组术后8 h[(2.45±0.36)分vs(2.82±0.42)分]、12 h[(2.50±0.36)分vs(2.91±0.52)分]、24 h[(2.72±0.51)分vs(3.32±0.60)分]均更低,差异有统计学意义(t=4.777、4.630、5.441,P<0.05);两组不良反应发生率差异无统计学意义(χ^(2)=0.239,P>0.05)。结论腹腔镜下全子宫切除术治疗中右美托咪定与纳布啡均可取得较好的镇痛镇静效果,相较之下纳布啡应用效果更佳,具备更好的临床应用价值。

Objective To compare the effects of dexmedetomidine and nalbuphine for analgesia and sedation after laparoscopic hysterectomy.Methods A total of 102 patients who underwent laparoscopic hysterectomy were selected and divided into a control group and an observation group from January 2017 to March 2020,with 51 cases in each group,according to the random number table method.The control group was treated with dexmedetomidine and the observation group was treated with nalbuphine.The Ramsay sedation score,the visual analogue scale(VAS)score and the occurrence of adverse reactions were compared between the two groups.Results Compared to the control group's Ramsay sedation score,the observation group was higher at 8 h[(4.18±0.33)points vs(3.65±0.35)points],12 h[(3.56±0.30)points vs(2.70±0.28)points],24 h[(2.80±0.32)points vs(2.55±0.25)points].The differences were statistically significant(t=7.868,14.966,4.397,P<0.05);compared with the VAS score of the control group,the VAS score of the observation group was lower at 8 h[(2.45±0.36)points vs(2.82±0.42)points],12 h[(2.50±0.36)points vs(2.91±0.52)points],24 h[(2.72±0.51)points vs(3.32±0.60)points].The differences were statistically significant(t=4.777,4.630,5.441,P<0.05);there was no statistically significant difference in the incidence of adverse reactions between the two groups(χ^(2)=0.239,P>0.05).Conclusion Both dexmedetomidine and nalbuphine in the treatment of laparoscopic total hysterectomy can achieve better analgesic and sedative effects.In contrast,nalbuphine has a better application effect and has better clinical application value.