摘要
目的探讨右美托咪定联合舒芬太尼自控静脉镇痛(PCIA)对妇科腹腔镜手术患者术后镇痛效果、炎症细胞因子及早期恢复的影响。方法选择2019年9月—2020年9月在该院接受妇科腹腔镜手术的100例患者作为研究对象。采用随机数表法均分两组,各50例。对照组给予舒芬太尼镇痛,观察组给予右美托咪定联合舒芬太尼镇痛。比较两组术后恢复情况,分析两组术后镇痛,记录麻醉诱导前(T0)、术毕(T1)、术后6 h(T2)及术后24 h(T3)时白细胞介素-6(IL-6)、白细胞介素-10(IL-10)及肿瘤坏死因子-α(TNF-α)变化,统计两组术后不良反应发生情况。结果观察组呼唤睁眼时间、定向力恢复时间及首次肛门排气时间均短于对照组(均P<0.05),两组术后住院时间比较,差异无统计学意义(P>0.05);两组患者T1、T2及T3时的拉姆齐镇静评分(RSS)和数字疼痛分级法(NRS)评分逐渐下降,观察组T1和T2时的RSS评分明显高于对照组,而NRS评分低于对照组(P<0.05);两组患者T1、T2及T3时的IL-6、IL-10及TNF-α表达水平均高于T0时,且观察组患者T1、T2及T3时的IL-6、TNF-α表达水平均低于对照组,IL-10表达水平高于对照组(P<0.05);观察组术后不良反应发生率(6.00%)低于对照组的22.00%(P<0.05)。结论右美托咪定联合舒芬太尼PCIA可提高妇科腹腔镜手术患者术后镇痛效果,抑制炎性反应,促进术后早日恢复,减少不良反应发生,临床运用价值较高。
Objective To investigate the effect of dexmedetomidine combined with sufentanil patient-controlled intravenous analgesia(PCIA) on postoperative analgesia,inflammatory cytokines and early recovery in patients undergoing gynecological laparoscopic surgery.Methods 100 patients who underwent gynecological laparoscopic surgery in our hospital from September 2019 to September 2020 were selected as the research object.They were randomly divided into two groups,50 cases in each group.The control group was given sufentanil for analgesia,and the observation group was given right metomidine and sufentanil.The postoperative recovery of the two groups was compared,and the postoperative analgesia was analyzed.The changes of IL-6,IL-10,TNF α,and the adverse reactions were recorded before anesthesia induction(T0),postoperative(T1),6 h(T2),24 h(T3) after operation.Results The time of eye opening,orientation recovery and first anal exhaust in the observation group were shorter than those in the control group(P< 0.05),and the postoperative hospital stay in the two groups was longer than that in the control group(P>0.05);The RSS and NRS scores at T1,T2 and T3 of the two groups decreased gradually.The Ramsey scale of sedation(RSS) score at T1 and T2 of the observation group was significantly higher than that of the control group,while the NRS score was lower than that of the control group(P< 0.05);the patients in the two groups were less than those in the control group(P< 0.05) The expression levels of IL-6,IL-10 and TNF-α at T1,T2 and T3 were higher than those at T0,and the expression levels of IL-6 and TNF-α at T1,T2 and T3 in the observation group were lower than those in the control group,and the expression level of IL-10 was higher than that in the control group(P< 0.05);the incidence of postoperative adverse reactions in the observation group was 6.00%,which was lower than 22.00% in the control group(P< 0.05).Conclusion The combination of dextrometropidine and sufentanil PCIA can improve the postoperative analgesic effect,in
作者
张豪杰
李健
屈献锋
王筱斐
ZHANG Hao-Jie;LI Jian;QU Xian-Feng(Taizhou Municipal Hospital,Taizhou,Zhejiang 318000,China)
出处
《中国妇幼保健》
CAS
2022年第2期202-205,共4页
Maternal and Child Health Care of China
基金
浙江省医学会临床科研基金项目(2012ZYC-A96)。
关键词
腹腔镜手术
妇科
舒芬太尼
右美托咪定
镇痛效果
炎症细胞因子
不良反应
Laparoscopic surgery
Gynecology
Sufentanil
Dextrometramidine
Analgesic effect
Inflammatory cytokines
Adverse reactions
