右美托咪定复合舒芬太尼对子宫全切术患者术后疼痛和睡眠质量的影响

Effects of dexmedetomidine combined with sufentanil on postoperative pain and sleep quality in patients undergoing total hysterectomy

目的研究右美托咪定复合舒芬太尼对子宫全切术患者术后疼痛和睡眠质量的影响。方法选取2018年11月至2020年12月在中国人民解放军陆军第七十三集团军医院进行子宫全切术的90例患者为研究对象,采用随机数字表法分为对照组和观察组,每组各45例。对照组患者术后给予舒芬太尼镇痛,观察组患者术后给予右美托咪定复合舒芬太尼镇痛。记录两组患者术后5h、24h、48h的视觉模拟评分法(visual analogue scale,VAS)评分,比较分析两组患者术前12h和术后12h、48h的睡眠质量,术前和术后48h的血清皮质醇、脑源性神经营养因子、白介素-6水平。结果术后5h、24h、48h,观察组患者的VAS评分均显著低于对照组(P<0.05)。术前12h,两组患者的睡眠质量指数比较差异无显著性(P>0.05);与术前12h比较,两组患者术后12h、48h的睡眠质量指数均显著降低,且观察组显著低于对照组(P<0.05)。术前,两组患者的血清皮质醇、脑源性神经营养因子、白介素-6水平比较差异均无显著性(P>0.05);与术前比较,两组患者术后48h的血清皮质醇、脑源性神经营养因子、白介素-6水平均显著降低,且观察组显著低于对照组(P<0.05)。结论右美托咪定复合舒芬太尼对子宫全切术患者的镇痛效果显著,且能有效改善患者的睡眠质量,减轻患者的应激反应和炎性反应,值得临床应用。

Objective To study the effects of dexmedetomidine combined with sufentanil on postoperative pain and sleep quality in total hysterectomy patients.Method 90 patients who underwent total hysterectomy in the 73rd Army Hospital of the Chinese People’s Liberation Army from November 2018 to December 2020 were selected as the research objects and randomly divided into control group and observation group,45 cases in each group.The control group was given sufentanil analgesia,and the observation group was given dexmedetomidine combined with sufentanil analgesia.The visual analogue scale(VAS)scores at 5h,24h and 48h after operation were observed.The sleep quality scores of the two groups were compared and analyzed at 12h before surgery,12h and 48h after surgery,and the serum cortisol(Cor),brain derived neurotrophic factor(BDNF),interleukin-6(IL-6)levels were compared between the two groups before surgery and at 48h after surgery.Result The VAS scores at 5h,24h and 48h in the observation group were significantly lower than those in the control group(P<0.05).There was no significant difference in sleep quality scores between the two groups at 12h before surgery(P>0.05).Compared with 12h before surgery,the sleep quality scores of two groups were significantly decreased at 12h and 48h after surgery,and the observation group was significantly lower than those in control group(P<0.05).Before surgery,the serum levels of Cor,BDNF,and IL-6 between the two groups were not significantly different(P>0.05);at 48h after operation,the Cor,BDNF and IL-6 of two groups were significantly decreased at 48h after surgery,and the observation group was significantly lower than those in control group(P<0.05).Conclusion Dexmedetomidine combined with sufentanil has significant analgesic effect on patients with total hysterectomy,and can effectively improve the sleep quality of patients,reduce the stress response and inflammatory response of patients,which is worthy of clinical application.