右美托咪定复合舒芬太尼在体外循环下心脏瓣膜置换术后镇痛中的应用效果观察  

Application of Dexmedetomidine Combined with Sufentanil for Analgesia after Cardiac Valve Replacement under Cardiopulmonary Bypass

作　　者：李青[1] LI Qing(Deyang People’s Hospital,Deyang 618000,China)

机构地区：[1]德阳市人民医院,四川德阳618000

出　　处：《中外医学研究》2019年第3期24-26,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探究右美托咪定复合舒芬太尼在体外循环下心脏瓣膜置换术后镇痛中的应用效果。方法:选取于笔者所在医院体外循环下行心脏瓣膜置换术患者94例,随机分为对照组(n=47)和观察组(n=47)。两组患者均采用静吸复合维持麻醉。观察组患者在关闭胸骨至手术结束静脉输注右美托咪,对照组则给予等量生理盐水。两组患者术后均行PCIA,对照组PCIA配方为舒芬太尼,观察组PCIA配方舒芬太尼+右美托咪定。对比术后,两组患者气管拔管时间,PCIA药液用量,吗啡使用率,患者术毕、术后6 h、术后24 h血清人肿瘤坏死因子α(TNF-α)、白介素-6(IL-6)、SI0013蛋白、神经元特异性烯醇化酶(NSE)的浓度。结果:两组患者气管拔管时间及PCAI药液用量比较,差异均无统计学意义(P>0.05);但术后观察组吗啡使用率为17.02%,显著低于对照组的27.66%,差异有统计学意义(P<0.05);术后6、24 h,观察组TNF-α、IL-6、SI0013蛋白及NSE水平均显著低于对照组,差异均有统计学意义(P<0.05)。结论:右美托咪定复合舒芬太尼可以减轻体外循环下心脏瓣膜置换术后患者炎症反应及应激反应程度,有利于患者脑组织的保护。Objective:To explore the effect of Dexmedetomidine combined with Sufentanil in analgesia after cardiopulmonary bypass under cardiopulmonary bypass.Method:A total of 97 patients with cardiac valve replacement underwent extracorporeal circulation were randomly divided into control group(n=47)and observation group(n=47).Patients in the observation group were treated with Dexmedetomidine Intravenously after the sternum was closed to the end of the operation.PCIA(Sufentanil+Dexmedetomidine)was given after operation.The control group received the same amount of normal saline during the operation,and PCIA was performed after operation(Sufentanil).The tracheal extubation time,PCIA drug dosage,morphine use rate,and serum TNF-α,IL-6,SI0013 protein and NSE concentrations were compared between the two groups.Result:There was no significant difference in tracheal extubation time and PCAI solution between the two groups(P>0.05).However,the morphine use rate(17.02%)in the observation group was lower than 27.66%of control group(P<0.05).At 6 h and 24 h after operation,the levels of TNF-α,IL-6,SI0013 protein and NSE in the observation group were significantly lower than those in the control group(P<0.05).Conclusion:Dexmedetomidine combined with Sufentanil can reduce the degree of inflammatory reaction and stress response in patients after cardiac valve replacement under cardiopulmonary bypass,which is beneficial to the protection of brain tissue.

关 键 词：右美托咪定 舒芬太尼 心脏瓣膜置换术 镇痛 

分 类 号：R614[医药卫生—麻醉学]