舒芬太尼联合右美托咪定对胃癌/结直肠癌根治患者术后镇痛及呼吸的影响

Effect of sufentanil combined with dexmedetomidine on postoperative analgesia and respiratory depression in patients undergoing aradical surgery of gastric cancer/colorectal cancer

目的研究舒芬太尼联合右美托咪定对胃癌/结直肠癌根治术患者术后镇痛效应及呼吸抑制的影响。方法将2018年8月—2020年8月收治的80例择期拟行胃癌/结直肠癌根治术治疗患者纳入研究。以随机数字表法将其分作观察组及对照组,每组各40例。对照组镇痛药物选用舒芬太尼,观察组镇痛药物的选用是在对照组的基础增用右美托咪定。分析两组镇痛、镇静效果,平均动脉压(MAP)以及血氧饱和度(SpO_(2))情况,不良反应,术后24 h舒芬太尼用量、经静脉患者自控镇痛(patient controlled intravenous analgesia,PCIA)用药量、追加镇痛药次数以及镇痛泵按压次数等方面的差异。结果两组视觉模拟评分法(VAS)及Ramsay评分在入室时比较,差异无统计学意义(P>0.05)。而在术后12、24、36、48 h时对比,观察组VAS评分相较于对照组更低,而Ramsay评分相较于对照组更高,差异有统计学意义(P<0.05)。两组入室时的MAP及SpO_(2)对比,差异无统计学意义(P>0.05)。而在术后12、24、36、48 h时对比,观察组MAP相较于对照组更低,差异有统计学意义(P<0.05)。在恶心呕吐发生率方面对比,观察组低于对照组,差异有统计学意义(P<0.05)。两组均无呼吸抑制的状况发生。两组的寒战、皮肤瘙痒、心动过缓、头晕的发生率差异无统计学意义(P>0.05)。观察组术后24 h舒芬太尼用量、PCIA用药量、追加镇痛药次数以及镇痛泵按压次数均低于对照组(均P<0.05)。结论舒芬太尼联合右美托咪定对胃癌/结直肠癌根治术患者的术后镇痛效应较佳,且不会引起呼吸抑制,可减少镇痛药物的应用以及镇痛泵按压次数。

Objective To evaluate the effect of sufentanil combined with dexmedetomidine on postoperative analgesic effect and respiratory depression in patients undergoing aradical surgery of gastric cancer/colorectal cancer.Methods From August 2018 to August 2020,80 patients admitted to our hospital for aradical surgery of gastric cancer/colorectal cancer were included in the study.The patients were divided into an observation group and a control group with 40 cases in each group by random number table method.Sufentanil was used as the analgesic agent for the control group,and dexmedetomidine was additionally used for the observation group.The analgesic and sedative effects,mean arterial pressure(MAP),blood oxygen saturation(SpO_(2)),the occurrence of adverse reactions,as well as the dosage of sufentanil,the dosage of PCIA,the number of additional analgesics,and the number of analgesic pump presses 24 h after surgery were analyzed between the two groups.Results There was no significant difference in VAS and Ramsay scores between the two groups before surgery(P>0.05).At 12 h,24 h,36 h,and 48 h after surgery,the VAS scores of the observation group were lower than those of the control group,while the Ramsay scores were higher(P<0.05).There were no significant differences in MAP and SpO_(2) between the two groups(P>0.05).At 12 h,24 h,36 h,and 48 h after operation,the MAP of the observation group was lower than that of the control group(P<0.05).The incidence rate of nausea and vomiting in the observation group was lower than that in the control group(P<0.05).There was no respiratory depression in the two groups.There were no significant differences in the incidence rates of chills,pruritus,bradycardia,and dizziness between the two groups(P>0.05).The dosage of sufentanil,the dosage of PCIA,the number of additional analgesics,and the number of analgesic pump presses in the observation group were all lower than those in the control group 24 h after operation(all P<0.05).Conclusion Sufentanil combined with dexmedetomidine has a better postoperative analgesic effect on patients with aradical surgery of gastric cancer/colorectal cancer,does not cause respiratory depression,and can reduce the use of analgesic drugs and the number of analgesic pump presses.