右美托咪定对舒芬太尼诱导中镇静镇痛的影响  

Impact of dexmedetomidine on analgesia and sedation effect during sufentanil anesthesia induction

作　　者：肖红霞[1] 

机构地区：[1]河南省濮阳市油田总医院麻醉科,河南濮阳457001

出　　处：《中国当代医药》2016年第2期106-108,111,共4页China Modern Medicine

摘　　要：目的探讨右美托咪定对妇科手术患者麻醉诱导期小剂量舒芬太尼镇痛和镇静效果的影响。方法 将2014年5月-2015年5月60例妇科手术患者均分为两组,每组30例。对照组：0.4μg/kg舒芬太尼＋10 ml生理盐水混静脉给药;观察组：采取0.4μg/kg舒芬太尼与稀释至50 ml的1μg/kg右美托咪定＋0.4μg/kg舒芬太尼。分别于给药前（T1）、应用生理盐水或右美托咪定后（T2）、最高清醒程度时（T3）及应用舒芬太尼后（T4）监测两组Nacotrend指数（NTI）,比较两组NTI数值在T3-T4时段内跌至最低值所用时间,记录两组右侧前臂0.1 cm2探头压痛痛阈（PPT）和耐痛阈（PTO）在T1与T4时的数值,记录两组RR水平变化。结果 观察组在T2时点的TNI数值明显低于对照组,组间比较差异有统计学意义（P〈0.05）;观察组NTI数值降至最低值所需时间较对照组短（P〈0.05）;观察组T4时点的PPT与PTO数值增幅明显高于对照组（P〈0.05）。应用舒芬太尼后观察组患者RR较对照组低（P〈0.05）。结论 小剂量应用舒芬太尼的基础上联合右美托咪定有利于增强镇痛效应,并缩短镇静药物作用起效时间,但有可能存在增加舒芬太尼呼吸抑制的风险,临床应慎重用药。Objective To explore the impact of dexmedetomidine on analgesia and sedation effect of patients with gynecological surgery anesthesia induction period by low dosage sufentanil. Methods 60 gynecological operation patients from May 2014 to May 2015 were divided into two groups,and each group was 30 cases.Patients in control group were treated with sufentanil（0.4 μg/kg） and 10 ml saline mix intravenous drug delivery,patients in observation group were treated with sufentanil（0.4 μg/kg） and diluted to 50 ml sufentanil（1 μg/kg）.Nacotrend index were respectively tested at the time of before treatment（T1）,after application saline or dexmedetomidine（T2）,the highest alert level（T3） and after application sufentanil（T4）.The time-taked that NTI values filled to the lowest at T3-T4 was compared between two groups.The value of right forearm 0.1 cm2 probe tenderness pain threshold and pain tolerance threshold at T1 and T4were recorded.The changes of RR level was recorded between two groups. Results The TNI value in observation group at T2 was obvious lower than that of control group,and the difference was statistical significance（P〈0.05）.The time-taked that NTI values filled to the lowest in observation group was shorter than that of control group（P〈0.05）.The increase of PPT and PTO values in observation group at T4 was obvious higher than that of control group respectively（P〈0.05）.After application of sufentanil,the RR in observation was slower than that of control group（P〈0.05）. Conclusion On the basis of low dosage sufentanil,combined with dexmedetomidine is helpful to enhance the analgesic effect and promotes the sedative drugs work to speed up.But may be increases risk of respiratory inhibition by sufentanil,so clinical should careful use.

关 键 词：妇科手术 舒芬太尼 右美托咪定 镇痛镇静 

分 类 号：R614.1[医药卫生—麻醉学]