右美托咪定复合舒芬太尼预镇痛对麻醉后应激反应的影响  

Preemptive analgesia effect of dexmedetomidine combined with sufentanil on stress reaction after anesthesia

作　　者：何燕娜 张县强 

机构地区：[1]广东惠东县人民医院麻醉科,广东惠东516300 [2]广东省惠东县安墩卫生院普外,广东惠东516329

出　　处：《海南医学院学报》2016年第12期1289-1291,共3页Journal of Hainan Medical University

基　　金：广东省科技计划项目(20110802)~~

摘　　要：目的：探讨右美托咪定复合舒芬太尼预镇痛对麻醉后应激反应的影响。方法：选择2014年5月～2015年8月我院接诊的120例腹腔镜手术患者进行观察,将入选患者随机分为观察组和对照组,每组60例,观察组麻醉前采用美托咪定复合舒芬太尼进行术前镇痛,对照组麻醉前采用舒芬太尼进行术前镇痛,对比2组患者手术前后免疫应激指标、应激激素指标变化及不良反应发生情况。结果：两组患者术前DTER、FEIR、CD3^＋、CD4^＋比较无明显差异（P〉0.05）;观察组患者术后DTER、CD3^＋、CD4^＋较对照组水平升高,FEIR水平低于对照组（P〈0.05）;两组患者术前的三项应激激素指标差异无统计学意义（P〉0.05）。观察组患者术后ACTH、Cor、ALD水平均低于对照组（P〈0.05）。观察组不良反发生率明显低于对照组（P〈0.05）。结论：腹腔镜手术患者使用右美托咪定复合舒芬太尼预进行术前镇痛,对患者应激反应影响较小,且不良反应发生率低,可做为腹腔镜手术术前镇痛的首选方案。Objective：To explore the e preemptive analgesia effect of dexmedetomidine combined with sufentanil on the stress reaction after anesthesia.Methods：A total of 120 patients who were admitted in our hospital from May,2014 to August,2015 for laparscopic surgery were included in the study and randomized into the observation group and the control group with 60 cases in each group.The patients in the observation group were given dexmedetomidine combined with sufentanil for preoperative analgesia before anesthesia,while the patients in the control group were given sufentanil.The changes of immunological stress indicators and stress hormone indicators before and after operation,and the occurrence of adverse reactions in the two groups were compared.Results：The difference of DTER,FEIR,CD3^＋,and CD4^＋before operation between the two groups was not statistically significant（P〈0.05）.DTER,CD3^＋,and CD4^＋levels after operation in the observation group were significantly elevated when compared with the control group,while FEIR level was significantly lower than that in the control group（P〈0.05）.The difference of three stress hormone indicators before operation between the two groups was not statistically significant（P〈0.05）.ACTH,Cor,and ALD levels after operation in the observation group were significantly lower than those in the control group（P〈0.05）.The occurrence rate of adverse reactions in the observation group was significantly lower than that in the control group（P〈0.05）.Conclusions：Preemptive analgesia of dexmedetomidine combined with sufentanil for patients underwent laparoscopic surgery has little effect on the stress reaction,with a low recurrence rate of adverse reactions;therefore,it can be used as a first choice for preemptive analgesia of laparoscopic surgery.

关 键 词：右美托咪定 舒芬太尼 预镇痛 麻醉 应激反应 

分 类 号：R614[医药卫生—麻醉学]