右美托咪定超前镇痛用于胃癌根治术的效果观察  

The Effect of Preemptive Analgesia of Dexmedetomidine on Patients with Radical Gastrectomy for Gastric Cancer

作　　者：宋文祥[1] 温来友[1] 胡永明[1] 吴文冬[1] 黄兵[1] 

机构地区：[1]东南大学医学院附属江阴医院麻醉科,江苏省江阴市214400

出　　处：《医学理论与实践》2017年第2期165-167,共3页The Journal of Medical Theory and Practice

摘　　要：目的:分析右美托咪定(Dex)超前镇痛在胃癌根治术中的应用效果。方法:选择2015年8月-2016年8月50例胃癌根治术患者,随机分为研究组25例和对照组25例。研究组在麻醉开始前10min静脉输注Dex 0.5μg/kg,后持续输注0.5μg/(kg·h)至术毕前60min,对照组输注相同剂量的瑞芬太尼。比较两组术毕、拔管即刻和拔管后5min平均动脉压(MAP)、心率(HR),记录两组拔管时间、拔管质量和定向力恢复时间,观察两组术后4h、8h、12h、24h视觉模拟评分(VAS)。结果:术毕、拔管后5min两组MAP、HR比较,差异无统计学意义(P>0.05),拔管即刻研究组MAP、HR明显低于对照组(P<0.05)。两组拔管时间和定向力恢复时间比较,差异无统计学意义(P>0.05),研究组拔管质量评分明显低于对照组(P<0.05)。研究组术后8h、12h、24hVAS评分显著低于对照组(P<0.05)。结论:Dex超前镇痛明显降低胃癌根治术患者拔管即刻的应激反应,改善拔管质量,减轻术后疼痛。Objective： To analyze the effect of preemptive analgesia of dexmedetomidine（Dex） on patients with radical gastrectomy for gastric cancer. Methods： 50 patients with gastric cancer selected from August 2015 to August 2016, were randomly divided into the study group and the control group with 25 cases in each group. Patients in the study group were given intravenous infusion of Dex 0. 5μg/kg in 10rain before anesthesia, then were given continuous infusion rate of 0. 5μg/（kg · h） until 60min before surgery, patients in the control group were injected with the same dose of remifentanil. Mean arterial pressure（MAP）, heart rate（HR） were compared in the two groups at the end of surgery, immediately after extubation and at 5min after extubation. Extubation time, extubation quality and recovery time of ori- entation were recorded. The visual analogue scale （VAS） at 4h, 8h, 12h and 24h in two groups were observed. Results： There were no significant differences in MAP and HR at the end of surgery, at 5rain after extubation in the two groups （P〉0. 05）, HR and MAP were significantly lower immediately after extubation in the study group than those in the control group （P〈0. 05）. There were no significant differences in extubation time and recovery time of orientation in the two groups （P〉0. 05）, and extubation quality in the study group was significantly better than that in the control group （P〈0. 05）. The VAS scores at postoperative 8h, 12h and 24h in the study group were significantly lower than those in the control group （P〈0. 05）. Conclusion： Preemptive analgesia of Dex significantly reduced the stress reaction immediately after extubation, improved the quality of extubation, reduced postoperative pain in patients with radical gastrectomy for gastric cancer.

关 键 词：右美托咪定 胃癌根治术 超前镇痛 效果 

分 类 号：R735.2[医药卫生—肿瘤]