右美托咪啶多模式用药的术后静脉自控镇痛效果评价  

Evaluation of effects of multi-mode administration of dexmedetomidine on patient-controlled intravenous analgesia after operation

作　　者：廖俊锋[1] 唐智豪 庞希友 

机构地区：[1]浙江大学金华医院-金华市中心医院麻醉科,金华321000

出　　处：《中国临床药学杂志》2016年第4期230-232,共3页Chinese Journal of Clinical Pharmacy

摘　　要：目的评价右美托咪啶多模式用药在开腹胃癌根治术术后镇痛的效果。方法采用随机数字表法将本院择期全身麻醉下开腹胃癌根治术患者60例分为观察组和对照组,每组30例。观察组术前15 min予右美托咪啶1μg·kg-1,术中予右美托咪啶0.3μg·kg-1·h-1持续泵注至手术结束前30 min停药,术后予舒芬太尼2μg·kg-1、托烷司琼5 mg、右美托咪啶2μg·kg-1加0.9%氯化钠溶液至100 m L行静脉自控镇痛(PCIA)。对照组不使用右美托咪啶,术后予舒芬太尼2μg·kg-1、托烷司琼5 mg加0.9%氯化钠溶液至100 m L行PCIA。2组静脉镇痛泵背景输注速度2 m L·h-1,自控给药剂量0.5 m L,锁定时间15 min。采用视觉模拟疼痛评分法(VAS)和Ramsay镇静评分(RSS)评价术毕0、4、8、12、24、48 h疼痛程度,记录恶心呕吐、寒战、心动过缓、呼吸抑制等不良反应的发生情况。结果观察组在术后各时间点VAS评分明显低于对照组(P<0.05),在术后0、4、8 h内时间点RSS明显高于对照组(P<0.05),在12、24、48 h 2组之间差异无统计学意义(P>0.05)。观察组不良反应发生率明显低于对照组(P<0.05)。结论右美托咪啶多模式用药明显提高了开腹胃癌根治术术后镇痛、镇静效果,减少了不良反应发生。AIM To evaluate the effects of multi-mode administration of dexmedetomidine on patient-controlled intravenous analgesia in patients after laptomy radical gastrectomy. METHODS Sixty patients scheduled for laparoto- my radical gastreetomy under general anesthesia in our hospital were divided into observation group （group D） and control group （group C） by using a random number table, each 30 patients. In group D, dexmedetomidine 1 μg·kg-1 were ad- ministrated by intravenous injection 15 min before induction of anesthesia, then 0.3 μg·kg-1. h-ldexmedetomidine was continuously administrated until 30 min before the end of operation. After surgery, for postoperative patient controlled in- travenous analgesia （PCIA） treatment , the group D were treated with sufentanil 2 μg·kg-1, tropisetron 5 mg and dexmedetomidine 2 μg·kg-1 that were diluted with normal saline to 100 mL. Group C did not use dexmedetomidine. The group C were treated with sufentanil 2μg·kg-1 and tropisetron 5 mg that were diluted with normal saline to 100 mL. The intravenous analgesia continuous perfusion amount was 2 mL· h-l, single bolus was 0.5 mL and lockout time was 15 min in 2 groups. The degree of pain and sedation grade in 2 groups were evaluated using visual analog scale（VAS）and Ram- say sedation score（RSS） after operation at 0,4,8,12,24 and 48 h. The occurrence of adverse reactions such as nausea and vomiting shivering bradyeardia and respiratory depression were recorded. RESULTS The postoperative VAS scores in the group D in all time points were significantly lower than those of the group C （ P 〈 0.05）. The Ramsay grades of the group D at 0,4,8 h were significantly higher than those of the group C （ P 〈 0.05）, there were no differences at 12, 24 and 48 h between the 2 groups （ P 〉 0.05）. The occurrence of adverse reactions in the group D were significantlylower than those of the group C （ P 〈 O. 05）. CONCLUSION Multi-mode administration of dexmedetomidine can obvi- ously improve the analges

关 键 词：多模式 右美托咪啶 胃癌根治术 术后镇痛 

分 类 号：R614[医药卫生—麻醉学]