盐酸右美托咪定辅助舒芬太尼术后镇痛研究

摘要

Objective To compare sufentanid assisted by dexmedetomidine hydrochloride for patient controlled in -travenous analgesia (PICA) with sufentanid used alone in PICA , then choose a better clinical plan of PICA. Methods Forty patients who received PICA voluntarily after thyroid gland and mammary glands operation were randomly divided in -to two groups. Sufentanid was used alone in control group , and sufentanid assisted by dexmedetomidine hydrochloride was used in experimental group. The score of analgesia and appeasement was recorded . The degree of satisfaction and compli -cation such as nausea, vomiting, dizziness, etc was also recorded. Results There was no statistically significant difference between experimental group and control group with respect to the resting visual analogue scale (VAS) scores at different postoperative time points (P >0. 05) , while dynamic VAS scores were lower in experimental group than in control group (P <0. 05). The incidence of nausea and vomiting was lower in experimental group than in control group (P <0. 05). Ramsay sedation scale scores were higher in experimental group than in control group (P <0.05). Conclusion Dexmedetomidine hydrochloride can enhancement analgesia of fentanids , reduce restlessness of patient.%目的 观察盐酸右美托咪定辅助舒芬太尼应用于患者静脉自控镇痛(PCIA),与单纯舒芬太尼用于 PCIA 进行对比,筛选出一种较好的 PCIA临床用药方案.方法 选择40例择期全麻下行甲状腺、乳腺手术,术后自愿行静脉镇痛泵治疗的患者,ASAⅠ～Ⅲ 级.随机分为2组,每组20例,对照组给予生理盐水+枸橼酸舒芬太尼0.04 μg·kg-1·h-1+托烷司琼4 mg静脉自控镇痛泵;实验组给予盐酸右美托咪定0.08 μg·kg-1·h-1+枸橼酸舒芬太尼0.025 μg·kg-1·h-1+托烷司琼4 mg静脉自控镇痛泵.术后记录各时点镇痛、镇静评分,观察是否有恶心、呕吐、眩晕、呼吸抑制及低氧血症等并发症及应用 PCIA 治疗的满意度评价.结果 术后各时点实验组患者静息时视觉模拟评分(VAS)较对照组差异无统计学意义(P＞0.05),动态VAS评分较对照组低(P＜0.05);恶心、呕吐发生率较对照组低(P<0.05);Ramsay镇静分级标准较对照组高(P<0.05).结论 右美托咪定作为一种术后辅助镇痛镇静药用于术后镇痛,能适度镇静,增强芬太尼类药物的镇痛作用,减少麻醉后患者躁动,降低恶心、呕吐等并发症的发生率.