摘要
目的观察右美托咪定在腹腔镜胆囊切除手术(laparoscopic cholecystectomy,LC)术后镇痛的临床效果.方法选取2015-06/2016-05慈林医院择期行LC的患者50例为研究对象,随机数字表法分为:右美托咪定组(D组)和舒芬太尼组(S组),各25例,D组术后静脉镇痛泵由右美托咪定0.2mg/(kg·h)用0.9%氯化钠溶液100 mL配制,S组由舒芬太尼1.5mg/kg用0.9%氯化钠溶液100 mL配制.记录2组患者手术后4、6、8、24和48 h的疼痛视觉模拟(visual analogue scale,VAS)评分和Ramsay镇静评分,并记录患者术后发生恶心呕吐、呼吸抑制和头晕的发生率和肠道功能恢复时间.结果 2组患者均未采用补救镇痛方案,术后4、6、8、24、48 h的VAS疼痛评分和Ramsay镇静评分均无显著差异(P>0.05).与S组相比,D组患者术后恶心呕吐的发生率明显减少,术后肠道功能恢复时间显著缩短,差异有统计学意义(P<0.05);2组患者呼吸抑制和头晕的发生率没有显著差异(P>0.05).结论右美托咪定用于LC术后镇痛可达到与舒芬太尼同等的镇痛效果,术后恶心呕吐的发生率更低,肠道功能恢复时间更短.
AIM To observe the clinical effects of dexmedetomidine for postoperative analgesia after laparoscopic cholecystectomy（LC）.METHODS From June 2015 to May 2016,50 patients undergoing LC were included in the study.They were divided into two groups：D（n=25）and S（n=25）.In group D,the patients were given dexmedetomidine diluted to 100 mL in0.9%saline at 0.2 μg/（kg·h） via a controlled intravenous analgesia pump.In group S,the patients were given sufentanil diluted to 100 mL in 0.9%saline at 1.5 μg/kg.The pain score on a visual analogue scale（VAS） and the Ramsay sedation score were recorded at 4,6,8,24,and48 h after the operation.The incidence rates of postoperative nausea and vomiting,respiratory depression,and dizziness,and the time to recovery of gastrointestinal function（time to first passage of flatus） were also recorded.RESULTS No patients received rescue analgesic agents.The VAS scores and Ramsay sedation scores at 4,6,8,24,and 48 h after the operation showed no significant differences between the two groups（P〉0.05）.Compared with group S,the incidence of postoperative nausea and vomiting was significantly reduced,and the time to the first passage of flatus was shorter in group D（P〈0.05）.The incidence rates of respiratory depression and dizziness were not significantly different between the two groups（P〉0.05）.CONCLUSION During the postoperative analgesia after LC,dexmedetomidine can achieve similar clinical analgesia effects to sufentanil with a lower rate of postoperative nausea and vomiting and shorter time to recovery of gastrointestinal function.
作者
杨凯杰
罗戎明
Kai-Jie Yang Rong-Ming Luo(Department of Anesthe- siology, CHC International Hospital, Cixi 315315, Zhejiang Province, China)
出处
《世界华人消化杂志》
CAS
2016年第36期4830-4834,共5页
World Chinese Journal of Digestology
关键词
右美托咪定
胆囊切除术
腹腔镜
静脉自控镇痛
Dexmedetomidine
Cholecystectomy
Laparoscopic
Patient controlled intravenous analgesia
