腹腔镜全子宫切除术中预注右美托咪定对术后舒芬太尼PCSA的影响  

Laparoscopic Hysterectomy in Pre-injection Given Dexmedetomidine Influence on Postoperative PCSA of Sufentanil

作　　者：张惠珍[1] 于振峰[1] 

机构地区：[1]内蒙古包头市蒙医中医医院麻醉科,内蒙古包头014000

出　　处：《中国医药指南》2015年第6期30-31,共2页Guide of China Medicine

摘　　要：目的 探讨在腹腔镜全子宫切除术中预注右美托咪定对术后舒芬太尼PCSA(患者自控皮下镇痛)的影响。方法 选择妇科腹腔镜全子宫切除术患者60例,随机分为两组,两组分别为30例患者。患者年龄、身高、体质量差异均无统计学意义(P<0.05)。A组(右美托咪定组)和B组(对照组)。A组患者在手术开始以0.1μg/(kg?h)泵注右美托咪定并在手术结束前10min停止泵注,B组以同样方式泵注等量生理盐水。两组患者手术结束后均带PCSA来镇痛。B组PCSA中含舒芬太尼2.5μg/kg+氯普鲁卡因0.6g+氟哌利多5mg加生理盐水到100mL。A组PCSA中舒芬太尼的剂量通过观察术后不良反应的变化随时调整。背景剂量:5mL/h,负荷剂量:3mL,锁定间隔时间:15min。记录术后PCSA舒芬太尼用量及患者恶心、呕吐和寒颤的发生情况。结果 与B组PCSA相比较,A组PCSA中的舒芬太尼从2.5μg/kg减少到2.0μg/kg,同样使患者得到满意的镇痛效果。A组(右美托咪定组)的恶心、呕吐等不良反应明显低于B组(对照组)(P<0.05)。结论 腹腔镜全子宫切除术中以0.1μg/(kg?h)预注右美托咪定可以减少术后PCSA中舒芬太尼用量,而且可使患者恶心、呕吐等不良反应的发生率大大降低。Objective To investigate the hysterectomy in pre-injection given dexmedetomidine influence on postoperative sufentanil PCSA（patientcontrolled analgesia subcutaneously） in laparoscopy. Methods 60 cases of laparoscopic hysterectomy surgery were randomly divided into two groups of 30 patients, respectively, age, height, weight difference was not statistically significant（P〉0.05）. A group（dextromethorphan detomidine group） and group B（control group）. A group of patients at the start of surgery to 0.1 μg/（kg·h） dexmedetomidine infusion set and 10 min before the end of surgery to stop pumping, group B in the same way normal saline infusion. After both groups of patients with surgery PCSA to analgesia. Group B PCSA containing sufentanil 2.5 μg/kg, chloroprocaine 0.6 g and droperidol 5 mg plus saline to 100 m L. A group PCSA changes in dose sufentanil through adverse reactions observed at any time after the adjustment. Background dose： 5 m L/h, loading dose： 3 m L, lock interval： 15 min. Postoperative PCSA sufentanil dosage and patient nausea, vomiting and chills of occurrence. Result The results compared with B group PCSA, A group of sufentanil PCSA from 2.5 μg/kg reduced to 2 μg/kg, so that patients get the same satisfaction analgesic effect, while the A group（dexmedetomidine given group） nausea, vomiting and other adverse reactions was significantly lower than in group B（control group）（P〈0.05）. Conclusion Laparoscopic hysterectomy to 0.1 μg/（kg·h） pre-injection given dexmedetomidine can not only reduce the amount of postoperative sufentanil PCSA and allows patients nausea, vomiting incidence of adverse reactions is greatly reduced.

关 键 词：预注 右美托咪定 舒芬太尼 术后PCSA 腹腔镜全子宫切除术 

分 类 号：R614[医药卫生—麻醉学]