右美托咪定对老年子宫全切术术后硬膜外吗啡镇痛的影响  

Effect of dexmedetomidine on postoperative epidural morphine analgesia in elderly patients with total hysterectomy

作　　者：张丽琴 欧阳胜[2] 

机构地区：[1]四川省乐山市市中区妇幼保健院麻醉科,四川乐山614000 [2]四川省内江市第一人民医院麻醉科,四川内江641000

出　　处：《实用临床医药杂志》2016年第9期79-81,共3页Journal of Clinical Medicine in Practice

基　　金：四川省自然科学基金(sc281223)

摘　　要：目的探讨右美托咪定对老年子宫全切术术后硬膜外吗啡镇痛的影响。方法 68老年子宫全切术患者随机分为观察组和对照组各34例。对照组输注生理盐水,观察组静注右美托咪定。结果观察组患者术后2、6、12、24 h的VAS疼痛评分均低于对照组,术后1、2、6、12、24 h的吗啡使用剂量低于对照组,术后2、24 h的血浆皮质醇浓度低于对照组,差异有统计学意义(P<0.05)。2组患者围术期心动过缓、低血压发生次数以及阿托品、麻黄碱的使用剂量比较,差异有统计学意义(P<0.01)。观察组患者的不良反应发生率显著低于对照组(P<0.05)。结论右美托咪定可以减少老年子宫全切术患者术后吗啡镇痛的用量,提高镇痛效果,降低不良反应发生率。Objective To explore the effect of dexmedetomidine on postoperative epidural morphine analgesia in elderly patients with total hysterectomy. Methods A total of 68 elderly patients with hysterectomy were randomly divided into observation group and control group,34 cases in each group. The control group was given saline infusion,and the observation group was given intravenous dexmedetomidine. Results The VAS scores at 2,6,12 and 24 h after treatment in the observation group were lower than those in the control group,morphine doses at 1,2,6,12 and 24 h after treatment were lower than the control group,plasma cortisol concentrations at 2 and 24 h were lower than the control group,and there were significant differences between two groups（ P〈 0. 05）. There were significant differences of perioperative bradycardia,hypotension and the atropine and ephedrine doses between two groups（ P〈 0. 01）. In the observation group,the incidence rate of adverse reactions was significantly lower than the control group（ P〈 0. 05）. Conclusion For the elderly patients with total hysterectomy,dexmedetomidine can reduce the dosage of postoperative morphine analgesia,improve the effect of analgesia and reduce the incidence rate of adverse reactions.

关 键 词：右美托咪定 子宫全切术 吗啡 镇痛 皮质醇 

分 类 号：R614[医药卫生—麻醉学]