不同剂量舒芬太尼复合右美托咪定术后自控静脉镇痛方案对直肠癌患者疼痛和炎症因子的影响

Effects of different doses of sufentanil combined with dexmedetomidine on postoperative controlled intravenous analgesia on pain and inflammatory factors in patients with rectal cancer

目的探究不同剂量舒芬太尼复合右美托咪定术后自控静脉镇痛(PCIA)方案对直肠癌患者疼痛和炎症因子的影响。方法选取2020年5月至2021年5月本院收治的择期行Dixon术的60例直肠癌患者作为研究对象,随机分为实验组(右美托咪定2μg/kg+舒芬太尼2μg/kg)、对照一组(右美托咪定2μg/kg+舒芬太尼1.5μg/kg)与对照二组(右美托咪定2μg/kg+舒芬太尼1μg/kg),每组20例,比较3组术后2 h(T0)、12 h(T1)、24 h(T2)、48 h(T3)各时间点视觉模拟评分法(VAS)评分、Ramsay镇静评分、炎症因子水平及不良反应发生率。结果T0、T1、T2、T3时刻,对照组VAS评分低于对照一组和对照二组,差异有统计学意义(P<0.05);对照一组、对照二组VAS评分比较差异无统计学意义。T0、T1、T2、T3时刻,3组Ramsay镇静评分比较差异无统计学意义。T0时刻,3组血清降钙素原(PCT)、C反应蛋白(CRP)水平比较差异无统计学意义;T1、T2和T3时刻,实验组PCT、CRP水平均低于对照一组和对照二组,差异有统计学意义(P<0.05)。术后3组不良反应发生率比较差异无统计学意义。结论采用右美托咪定2μg/kg+舒芬太尼2μg/kg用于直肠癌术后自控镇痛效果最佳,可有效降低炎症反应,值得临床推广应用。

Objective To explore the effect of different doses of sufentanil combined with dexmedetomidine on postoperative controlled intravenous analgesia(PCIA)on pain and inflammatory factors in patients with rectal cancerr.Methods 60 rectal cancer patients who underwent Dixon surgery on selective basis in our hospital from May 2020 to May 2021 were selected as the research subjects,and they were randomly divided into experimental group(dexmedetomidine 2μg/kg+sufentanil 2μg/kg),control group 1(dexmedetomidine 2μg/kg+sufentanil 1.5μg/kg)and control group 2(dexmedetomidine 2μg/kg+sufentanil 1μg/kg),with 20 cases in each group,the visual analogue scale(VAS)score,Ramsay sedation score and inflammatory factor level at 2 h(T0),12 h(T1),24 h(T2)and 48 h(T3)and he incidence of adverse reactions after operation were compared among the three groups.Results At T0,T1,T2 and T3,the VAS score of the experimental group was lower than that of the control group 1 and the control group 2,and the difference was statistically significant(P<0.05);there was no significant difference in VAS scores between the control group 1 and the control group 2.At T0,T1,T2 and T3,there was no significant difference in Ramsay sedation score among the three groups.At T0,there was no significant difference in the levels of procalcitonin(PCT)and C-reactive protein(CRP)among the three groups;at T1,T2 and T3,the levels of PCT and CRP in the experimental group were lower than those in the control group 1 and the control group 2(P<0.05).There was no significant difference in the incidence of adverse reactions among the three groups.Conclusion Dexmedetomidine 2μg/kg+sufentanil 2μg/kg for patient controlled intravenous analgesia on pain and inflammatory factors in patients with rectal cancer has the best effect,can effectively reduce the inflammatory response,worthy of clinical application.