右美托咪定复合舒芬太尼在全身麻醉腹腔镜下子宫切除术患者术后镇痛中的应用

Application of dexmedetomidine combined with sufentanil in postoperative analgesia in patients undergoing laparoscopic hysterectomy under general anesthesia

目的探讨右美托咪定复合舒芬太尼在全身麻醉腹腔镜子宫切除术患者术后镇痛中的应用价值。方法选取2020年4月至2021年4月本院收治的70例行全身麻醉腹腔镜子宫切除术的患者作为研究对象,采用随机数字表法分为对照组和观察组,每组35例。对照组给予舒芬太尼术后镇痛,观察组给予右美托咪定复合舒芬太尼术后镇痛。比较两组术后视觉模拟评分法(VAS)评分、Ramsay镇静评分表评分、舒芬太尼累积消耗量、睡眠质量及不良反应发生情况。结果术后2、6、12、24、48 h,观察组VAS评分均低于对照组,差异有统计学意义(P<0.05)。术后2、6、12 h,观察组Ramsay评分均高于对照组,差异有统计学意义(P<0.05);术后24、48 h,两组Ramsay评分比较差异无统计学意义。术后2、6、12、24、48 h,观察组舒芬太尼累积消耗量均少于对照组,差异有统计学意义(P<0.05)。术后1周,观察组每日睡眠时间长于对照组,睡眠障碍指数(SPI)低于对照组,差异有统计学意义(P<0.05)。结论右美托咪定复合舒芬太尼在全身麻醉腹腔镜下子宫切除术患者中镇痛效果优于舒芬太尼,可减少舒芬太尼使用剂量,改善患者术后睡眠质量。

Objective To investigate the application of dexmedetomidine combined with sufentanil in postoperative analgesia in patients undergoing laparoscopic hysterectomy under general anesthesia.Methods 70 patients who underwent laparoscopic hysterectomy under general anesthesia in our hospital from April 2020 to April 2021 were selected as the research subjects,and they were divided into the control group and the observation group according to random number table method,with 35 cases in each group.The control group was given sufentanil for postoperative analgesia,and the observation group was given dexmedetomidine combined with sufentanil for postoperative analgesia.The postoperative visual analogue scale(VAS)score,Ramsay sedation scale score,cumulative consumption of sufentanil,sleep quality and adverse reactions were compared between the two groups.Results At 2,6,12,24,48 h after operation,The VAS scores of the observation group were lower than those of the control group,and the difference was statistically significant(P<0.05).At 2,6,12 h after operation,the Ramsay score of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).At 2,6,12,24,48 h after operation,the cumulative consumption of sufentanil in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).1 week after operation,the daily sleep time in the observation group was longer than that in the control group,and the sleep disorder indexl(SPI)was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion Dexmedetomidine combined with sufentanil has better analgesic effect than sufentanil in patients undergoing laparoscopic hysterectomy under general anesthesia.which can reduce the dosage of sufentanil and improve the postoperative sleep quality of patients.