摘要
目的探讨右美托咪定复合舒芬太尼对胸腔镜肺叶切除患者术后镇痛的影响。方法选择择期行胸腔镜肺叶切除术患者60例,随机均分为右美组(DS组)和对照组(S组)。两组术后均采用PCIA,DS组:右美托咪定2.0μg/kg+舒芬太尼1.5μg/kg+昂丹司琼8 mg;S组:舒芬太尼2.0μg/kg+昂丹司琼8 mg,均用生理盐水稀释至100 m L。参数设置:负荷剂量2 m L,维持速率2 m L/h,PCA剂量2 m L/次,锁定时间15 min。记录术后2、6、12、24、36、48 h的平均动脉压(MAP)、心率(HR)、静息(VASR)和咳嗽(VASC)VAS评分、Ramsay镇静评分。记录术后48 h内镇痛泵按压次数、舒芬太尼使用量、恶心呕吐、呼吸抑制、心动过缓等不良反应发生情况。结果与S组比较,DS组患者各时点MAP、HR明显降低(P<0.05),术后6、12、24 h VASR、VASC评分明显降低(P<0.05),术后48 h内镇痛泵按压次数、舒芬太尼使用量、术后48 h内恶心呕吐发生率明显降低(P<0.05)。结论胸腔镜肺叶切除患者术后PCIA使用右美托咪定复合舒芬太尼不仅能获得满意的镇痛效果且血流动力学更稳定,同时减少舒芬太尼用量,降低恶心呕吐发生率。
Objective To investigate the effect of dexmedetomidine combined with sufentanil on postoperative analgesia in patients undergoing thoracoscopic lobectomy. Methods Sixty patients undergoing tboracoscopic lobectomy were randomly divided into the dexmedetomidine group （DS group） and the control group （S group）. The two groups were treated with PCIA. The Group DS ： dexmedetomidine 2 μg/kg ＋ sufentanil 1.5μg/kg ＋ ondansetron 8 mg; and the group S： sufentanil 2 μg/kg ＋ ondansetron 8 mg, in which all drugs were dissolved in 100 mL 0.9 normal saline. Parameters： loading dose 2 mL; infusion speed 2 mL/h; PCA dosage 2 mL each time; lock time： 15 min. The mean arterial pressure （MAP） , heart rate （HR） , resting （VASR） and cough （VASC） VAS score, and Ramsay sedation score were recorded at 2, 6, 12, 24, 36 and 48 h after surgery. The number of press analgesic pump, the amount of sufentanil used, the incidence of adverse reactions such as, the nausea and vomiting, respiratory depression, bradycardia and so on were recorded within 48 h after operation. Results Compared with the group S, the MAP and HR of patients in the group DS decreased significantly at each time （P 〈 0.05）, the scores of VASR and VASC decreased obviously at 6, 12, 24 h after surgery （P 〈 0.05）, the number of press analgesic pump, the amount of sufentanil used, the incidence of nausea and vomiting decreased obviously within 48 h after operation （P 〈 0.05 ）. Conclusions Dexmedetomidine combined sufentanil administration in PCIA after thoracoscopic lobectomy can obtain satisfactory analgesic effect and more stable hemodynamics, and reduce the dosage of sufentanil, the incidence of nausea and vomiting.
出处
《实用医学杂志》
CAS
北大核心
2018年第3期453-456,共4页
The Journal of Practical Medicine
基金
揭阳市卫生医疗科技计划项目(编号:0019024141202042)
