摘要
目的探讨右美托咪定（dexmedetomidine，Dex）配伍应用氟比洛芬酯对腹腔镜子宫切除术后氟比洛芬酯自控静脉镇痛效果的影响。方法将我院2014年1月～2015年12月经腹腔镜子宫切除术患者60例作为研究对象，分为氟比洛芬酯组（F组）与Dex配伍氟比洛芬酯组（DF组），每组30例。DF组在手术结束前30min静脉泵注（15min）Dex0．5μg／kg，F组静脉给予同等容量的生理盐水代替。两组手术结束后均行统一的氟比洛芬酯自控静脉镇痛，观察不同时间点镇痛视觉模拟评分（viaual analogue scale，VAS）、镇静评分（amsay sedation scores）、舒适评分（BCS评分）、镇痛泵按压次数及心率（HR）、平均动脉压（MAP）及术后48h内其他不良反应的发生情况。结果术后8h内DF组的VAS评分、BCS评分、镇痛泵按压次数较F组显著降低，差异有统计学意义（P〈0．05）；DF组在术后1h的HR、MAP均较F组显著降低，差异有统计学意义（P〈0．05）；DF组术后的恶心、呕吐发生率较F组显著降低，差异有统计学意义（P〈0．05）。但术后两组Ramsay评分差异无统计学意义。结论手术结束前30min静脉缓慢泵注0．5μg，kg的Dex可有效减轻患者术后疼痛，使术后患者血流动力学更加平稳，减少应激反应和术后副反应。
Objective To discuss the influence of combined dexmedetomidine （Dex） on patient-controlled analgesia effect of flurbiprofen axetil after laparoseopic hysterectomy. Methods 60 patients receiving laparoscopic hysterectomy in our hospital from January 2014 to December 2015 were selected and divided into the flurbiprofen axetil group （group F） and the Dex with flurbiprofen axetil group （group DF）, each with 30 patients. Patients in group DF were injected Dex 0.5μg/kg by intravenous pumping for 15 min at half an hour before the end of operation, while patients in group F were given equal volume of normal saline by intravenous administration. After operation, patients in both groups were managed by flurbiprofen axetil patient controlled intravenous analgesia, and parameters at different time points were ob- served, including visual analogue scale （VAS） of pain, Ramsay sedation scores, Bruggman comfort scale （BCS）, pressing times of analgesia pump, heart rate （HR）, mean arterial pressure （MAP）, and adverse events within 48h after operation. Results The VAS, BCS and pressing times of analgesia pump were significantly lower in group DF than in group F within 8h after operation （P〈0.05）. The HR and MAP were significantly lower in group DF than in group F within 1 h after operation （P〈0.05）. The incidence rates of nausea and vomiting were significantly lower in group DF than in group F after operation （P〈0.05）. There was no significant difference in Ramsay sedation scores between two groups after operation. Conclusion Slow pumping of Dex 0.5 μg/kg intravenously at 30min before the end of operation can effectively relieve the patients＇ pain after operation, stabilize the hemodynamics of patients, and reduce stress reactions and side reactions after operation.
出处
《中国现代医生》
2016年第14期119-123,共5页
China Modern Doctor
基金
浙江省医药卫生科技计划项目(2015KYB452)
关键词
右美托咪定
腹腔镜
子宫切除术
氟比洛芬酯
自控镇痛
影响
Dexmedetomidine
Laparoscope
Hysterectomy
Flurbiprofen axetil
Patient-controlled analgesia
Influence
