右美托咪定联合布托啡诺在颌面外科术后镇痛中的应用效果  

Application effect of dexmedetomidine combined with butorphanol on postoperative analgesia in maxillofacial surgery

作　　者：李美胜[1] 罗林[1] 吉阳[1] 王淼[1] LI Mei-sheng;LUO Lin;JI Yang;WANG Miao(Department of Anesthesiology,West China Hospital of Stomatology,Sichuan University,State Key Laboratory of Oral Diseases,National Clinical Research Center for Oral Diseases,Chengdu 610041,China)

机构地区：[1]四川大学华西口腔医院麻醉科,口腔疾病研究国家重点实验室,国家口腔疾病临床医学研究中心,成都市610041

出　　处：《广西医学》2018年第24期2904-2907,共4页Guangxi Medical Journal

摘　　要：目的探讨右美托咪定联合布托啡诺在颌面外科术后镇痛中的应用效果。方法将80例行颌面外科手术患者随机分为观察组和对照组各40例。观察组采用右美托咪定联合布托啡诺进行术后镇痛,对照组采用舒芬太尼联合托烷司琼进行术后镇痛。比较两组患者术后1 h、2 h、6 h、12 h、24 h、48 h时的疼痛评分及镇静评分,术后24 h镇痛泵总按压次数及镇痛药物总用量,以及术后1周内不良反应发生情况。结果术后各时间点,观察组患者的疼痛视觉模拟量表评分均低于对照组,Ramsay镇静评分均高于对照组(均P <0. 05)。观察组不良反应发生率低于对照组,术后24 h镇痛泵总按压次数和镇痛药物总用量均少于对照组(均P <0. 05)。结论与常规方案比较,颌面外科术后采用右美托咪定联合布托啡诺镇痛、镇静效果更好,并可减少药物使用量,不良反应发生率更低。Objective To investigate the effect of dexmedetomidine combined with butorphanol applied to analgesia after maxillofacial surgery.Methods Eighty patients undergoing maxillofacial surgery were randomly divided into observation group and control group,with 40 cases in each group.The observation group was treated with dexmedetomidine combined with butorphanol for postoperative analgesia,and the control group was treated with sufentanil combined with tropisetron for postoperative analgesia.The pain scores and sedation scores were compared between the two groups at 1,2,6,12,24,48 hours after operation,the total number of analgesic pump press,and total analgesic dose at 24 hours after operation,as well as the incidence of adverse reactions within one week after operation were compared as well.Results At each time point postoperatively,the Visual Analogue Scale pain score was lower and the Ramsay sedation score was higher in the observation group than those in the control group(all P<0.05).The observation group had lower incidence rate of adverse reactions,smaller total number of analgesic pump press and less total analgesic dose at 24 hours after operation compared with the control group(all P<0.05).Conclusion Compared with conventional regimen,the combination of dexmedetomidine and butorphanol for postoperative analgesia in maxillofacial surgery has better analgesic and sedative effects,which can reduce the dose of opioids,with a lower incidence rate of adverse reactions.

关 键 词：颌面外科 术后镇痛 右美托咪定 布托啡诺 

分 类 号：R782[医药卫生—口腔医学]