右美托咪定预处理对胃癌根治术患者术后静脉镇痛的影响

Effect of dexmedetomidine preconditioning on intravenous analgesia in patients undergoing radical gastrectomy

目的探讨右美托咪定预处理对胃癌根治术患者术后静脉镇痛的影响。方法选择择期行胃癌根治术患者60例为研究对象,随机均分为静脉泵注右美托咪定组(D组)和静脉泵注0.9%氯化钠溶液组(C组),每组30例。D组患者诱导前静脉泵注负荷量右美托咪定1μg/(kg·10 min),泵注结束后调节泵速进行维持在0.2~0.7μg/(kg·h),手术结束前30 min停止泵注;C组患者以同样的方法泵注0.9%氯化钠溶液。记录术后2、4、6、24 h视觉模拟评分法(VAS)评分及拉姆齐镇静评分法(RSS)评分和按压镇痛泵的次数,观察术后24 h低血压、恶心呕吐、眩晕等不良反应的发生情况。结果术后6 h内2组患者按压镇痛泵次数D组患者明显少于C组(P<0.05);D组患者VAS评分、RSS镇静评分优于C组(P<0.05);术后24 h内低血压、恶心呕吐、眩晕等不良反应发生率D组患者明显低于C组患者(P<0.05)。结论右美托咪定预处理可减少胃癌根治术患者术后舒芬太尼用量及不良反应的发生。

Objective To discuss effect of dexmedetomidine preconditioning on intravenous analgesia in patients undergoing radical gastrectomy.Methods A total of 60 patients who underwent elective radical gastrectomy were enrolled this study.Patients were randomly divided into group D(n=30)and group C(n=30).Group D received loading dose of dexmedetomidine 1μg/kg for 10 minutes,and then adjust the dose to 0.2~0.7μg/(kg·h)and stopping pumping 30 min before the end of surgery.Patients in group C received normal saline i in the same way.Visual analogue scale(VAS)scores,Ramsay sedation scores(RSS)scores and the number of pressing analgesia pump were estimated at 2 h,4 h,6 h,24 h after the operation.Observe the occurrence of adverse reactions such as hypotension,nausea and vomiting,and dizziness at 24 hours after operation.Results There was no significant difference in general data between the two groups(P>0.05).Within 6h after operation,the number of pressing analgesic pump in group D was significantly lower than that in group C(P<0.05);Within 6 h after surgery,VAS score and RSS sedation score in group D were better than those in group C(P<0.05).Within 24h after operation,the incidence of hypotension,nausea,vomiting,vertigo and other adverse reactions in group D was significantly lower than that in group C(P<0.05).Conclusion Dexmedetomidine pretreatment can reduce the dosage of sufentanil and the incidence of adverse reactions after radical gastrectomy.