摘要
目的有效的术前镇痛有利于缓解患者术后疼痛,减轻术后应激反应。本研究观察腹腔镜手术患者应用右美托咪定联合舒芬太尼术前镇痛的效果。方法选取2016-01-03-12-03光山县中医院收治的行腹腔镜手术患者88例作为研究对象,根据术前镇痛方式的不同将患者分为对照组和观察组,各44例。对照组给予舒芬太尼行术前镇痛,观察组给予右美托咪定联合舒芬太尼行术前镇痛。比较两组镇痛效果及手术前后应激反应的变化情况。结果两组术前醛固酮(aldosterone,ALD)、皮质醇(cortisol,Cor)以及促肾上腺皮质激素(adrenocorticotropic hormone,ACTH)水平对比,差异无统计学意义,均P>0.05;观察组和对照组术后ALD分别为(121.52±10.28)和(151.25±12.41)pg/mL,t=12.238,P<0.001;Cor分别为(208.69±18.58)和(232.36±22.52)ng/mL,t=5.378,P<0.001;ACTH分别为(19.25±1.34)和(25.41±2.01)ng/L,t=16.915,P<0.001,差异均有统计学意义。术后1h,两组VAS评分比较差异无统计学意义,P>0.05。术后24h,观察组VAS评分为(0.62±0.41)分,低于对照组的(1.33±0.67)分,差异有统计学意义,t=5.996,P<0.05。结论腹腔镜手术患者应用右美托咪定联合舒芬太尼术前镇痛效果理想,利于减轻患者术后应激反应,缓解疼痛。
OBJECTIVE Effective preoperative analgesia for surgical patients is beneficial to relieve postoperative pain and to reduce postoperative stress response.This study is to observe the effect of dexmedetomidine combined with sufentanil as preoperative analgesia in patients undergoing laparoscopic surgery.METHODS A total of 88 patients undergoing laparoscopic surgery treated in Guangshan County Hospital of Traditional Chinese Medicine from January 3,2016 to December 3,2016 were divided into control group and observation group according to the different ways of analgesic mode,with 44 cases in each group.The control group was given sufentanil for preoperative analgesia,while the observation group was given dexmedetomidine combined with sufentanil for analgesia before operation.The analgesic effect and the changes of stress response before and after operation were compared between the two groups.RESULTS There was no statistically significant difference in the levels of aldosterone（ALD）,cortisol（Cor）and adrenocorticotropic hormone（ACTH）before operation,all P〈0.05.After operation,The ALD of the observation group and the control group were（121.52±10.28）pg/mL vs（151.25±12.41）pg/mL,t=12.238,P〈0.001,Cor were（208.69±18.58）ng/mL vs（232.36±22.52）ng/mL,t=5.378,P〈0.001.ACTH were（19.25±1.34）ng/L vs（25.41±2.01）ng/L,t=16.915,P〈0.001,and the differences were statistically significant.There was no significant difference in the VAS score between the two groups at 1 hafter operation,P〈0.05.After 24 h,the VAS score of the observation group[（0.62±0.41）score]was remarkably lower than that of the control group[（1.33±0.67）score],the difference was statistically significant（t=5.996,P〈0.05）.After 24 h,the VAS score of the observation group was（0.62±0.41）score,lower than that of the control group（1.33±0.67）score,the difference was statistically significant,t=5.996,P〈0.05.CONCLUSION The peoperative application of dexmedetomidine combined with sufentanil in laparoscopi
作者
严华
YAN Hua(Department of Anesthesiology ,Guangshan County Hospital of Traditional Chinese Medicine ,Guangshan 465450, P. R. China)
出处
《社区医学杂志》
2018年第13期1105-1107,共3页
Journal Of Community Medicine
关键词
舒芬太尼
右美托咪定
镇痛
腹腔镜手术
应激反应
sufentanil
dexmedetornidine
analgesia
laparoscopic surgery
stress response
