右美托咪定联合舒芬太尼在子宫切除手术后的镇痛效果及对清醒时间的影响

Analgesic Effect of Dexmedetomidine Combined with Sufentanil after Hysterectomy and Its Effect on Wakefulness Time

目的探究右美托咪定联合舒芬太尼在子宫切除手术后的镇痛效果及对清醒时间的影响。方法随机选取2021年3月—2023年3月厦门市妇幼保健院择期进行子宫切除手术治疗的患者80例,依照抽签法随机分为观察组与对照组,每组40例。对照组术后采用舒芬太尼镇痛方案,观察组术后采用右美托咪定联合舒芬太尼镇痛方案,比较两组镇痛效果。结果观察组术后1、6、24 h的视觉模拟评分与Ramsay评分均优于对照组,差异有统计学意义(P<0.05)。术后24 h,观察组皮质醇、前列腺素E2、去甲肾上腺素水平低于对照组,差异有统计学意义(P<0.05)。观察组术后清醒时间短于对照组,术后24 h舒芬太尼用量少于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率(7.50%)低于对照组(25.00%),差异有统计学意义(χ^(2)=4.501,P<0.05)。结论在子宫切除手术后采用右美托咪定联合舒芬太尼镇痛方案,起到显著的镇痛及镇静效果,可进一步有效抑制术源性应激反应,促进患者术后尽快恢复至清醒状态,减低舒芬太尼用量,且对提高患者术后安全性有积极意义。

Objective To investigate the analgesic effect of dexmedetomidine combined with sufentanil after hysterectomy and the effect on wakefulness time.Methods 80 patients who underwent elective hysterectomy surgery at Xiamen Maternal and Child Health Hospital from March 2021 to March 2023 were randomly selected,and randomly divided into an observation group and a control group according to the lottery method,with 40 patients in each group.The control group received postoperative analgesia with sufentanil,while the observation group received postoperative analgesia with dexmedetomidine combined with sufentanil.The analgesic effects of the two groups were compared.Results The VAS and Ramsay scores of the observation group at 1 hours,6 hours,and 24 hours after surgery were better than those of the control group,the difference was statistically significant(P<0.05).24 hours after surgery,the levels of Cor,PGE2,and NE in the observation group were lower than those in the control group,the difference was statistically significant(P<0.05).The postoperative wakefulness time of the observation group was shorter than that of the control group,and the amount of sufentanil used 24 hours after surgery was less than that of the control group,the difference was statistically significant(P<0.05).The incidence of adverse reactions in the observation group(7.50%)was lower than that in the control group(25.00%),the difference was statistically significant(χ^(2)=4.501,P<0.05).Conclusion The use of dexmedetomidine combined with sufentanil analgesic program after hysterectomy plays a significant analgesic and sedative effect,which can further effectively inhibit the operative stress response,promote the patients´postoperative recovery to wakefulness as soon as possible,and reduce the dosage of sufentanil,and has a positive sig-nificance in improving the safety of the patients in the postoperative period.