右美托咪定联合芬太尼在胸腔镜下肺叶切除术术后自控静脉镇痛中的应用  

Application of dexmedetomidine combined with fentanyl in postoperative patient-controlled intravenous analgesia after thoracoscopic lobectomy

作　　者：丁壬娴[1] 单希胜[1] DING Ren-xian SHAN Xi-sheng.(Suzhou University First Affiliated Hospital, Suzhou 215006, China)

机构地区：[1]苏州大学附属第一医院,215006

出　　处：《中国实用医药》2017年第29期100-102,共3页China Practical Medicine

摘　　要：目的探索右美托咪定(DEX)与芬太尼联合应用于胸腔镜下肺叶切除术术后自控静脉镇痛的效果。方法 70例行胸腔镜肺叶切除术患者,根据术后静脉镇痛泵中应用药物不同分为DEX组和对照组,每组35例。DEX组术后镇痛应用芬太尼和DEX;对照组术后镇痛使用芬太尼。记录术后24 h各个时间段(术后2、4、8、12、24 h)镇痛药物使用总量、视觉模拟评分法(VAS)评分及经静脉患者自控镇痛(PCIA)相关并发症。结果 DEX组患者在术后24 h内各时间段芬太尼消耗量明显少于对照组,差异有统计学意义(P<0.05),术后24 h芬太尼消耗量,DEX组比对照组减少15%。两组患者在术后24 h内各时间点VAS评分比较差异无统计学意义(P>0.05)。DEX组术后发生恶心、呕吐发生率与对照组比较差异无统计学意义(P>0.05);DEX组不良反应总发生率(8.6%)低于对照组(28.6%),差异有统计学意义(P<0.05)。结论 DEX辅助芬太尼术后镇痛,临床反应好,不良反应少,可以提高术后镇痛舒适度,值得临床推广。Objective To investigate the effect of dexmedetomidine（DEX） combined with fentanyl in postoperative patient-controlled intravenous analgesia after thoracoscopic lobectomy.Methods A total of 70 patients undergoing thoracoscopic lobectomy were divided by different drugs in postoperative patient-controlled intravenous analgesia into DEX group and control group,with 35 cases in each group.DEX group received fentanyl and DEX for postoperative analgesia,and the control group received fentanyl for postoperative analgesia.Record were made on total dose of analgesic drugs,visual analogue scale（VAS） score,and patient-controlled intravenous analgesia（PCIA） related complications were measured at all time points of postoperative 24 h（postoperative 2,4,8,12）.Results DEX group had obviously less fentanyl consumption at all time points of postoperative 24 h than the control group,and the difference was statistically significant（P〈0.05）.Fentanyl consumption in postoperative 24 h was 15% lower in the DEX group than in the control group.Both groups had no statistically significant difference in VAS score at all time points of postoperative 24 h（P〉0.05）.DEX group had no statistically significant difference in incidence of postoperative nausea and vomiting,comparing with the control group（P〉0.05）.DEX group had lower incidence of total adverse reactions（8.6%） than the control group（28.6%）,and the difference was statistically significant（P〈0.05）.Conclusion DEX assisted fentanyl postoperative analgesia shows good clinical response and less adverse reactions,and it can improve postoperative analgesic comfort.It is worthy of clinical promotion.

关 键 词：右美托咪定 术后镇痛 肺叶切除术 经静脉患者自控镇痛 

分 类 号：R614[医药卫生—麻醉学]