右美托咪定超前镇痛对妇科腹腔镜手术患者术后疼痛的影响  

Effects of dexmetomidine preemptive analgesia on postoperative pain in patients undergoing gynecological laparoscopic surgery

作　　者：刘新法[1] 张杰[1] 谢国柱[1] Liu Xinfa;Zhang Jie;Xie Guozhu(Department of Anesthesiology,Taizhou People's Hospital of Jiangsu,Taizhou,Jiangsu,225300,China)

机构地区：[1]江苏省泰州市人民医院麻醉科

出　　处：《当代医学》2019年第35期9-12,共4页Contemporary Medicine

摘　　要：目的观察并研究妇科腹腔镜手术患者应用右美托咪定对术后镇痛的影响.方法随机选择90例妇科腹腔镜全麻手术患者,根据不同药物给药方式分为对照组(C组)、试验1组(D1组)及试验2组(D2组),每组30例;记录患者术中、术后24 h消耗舒芬太尼的量及术后24 h内有效按压镇痛泵的次数;记录3组患者术后各时间点的VAS镇痛、Ramsay镇静评分、不良反应情况、术后满意度.结果术后镇痛泵有效按压次数,3组之间比较差异有统计学意义(P<0.05);3组患者术后1 h(T2)VAS镇痛评分、Ramsay评分两两比较,差异有统计学意义(P<0.05);术后8 h(T5)镇痛VAS评分两两比较差异有统计学意义(P<0.05);C组患者恶心、呕吐发生率显著高于D1组、D2组差异具有统计学意义;术后D2组患者总体满意度与C组、D1组比较,差异均有统计学意义(P<0.05).结论右美托咪定超前镇痛可以减少不良反应,降低VAS评分,提高患者满意度.Objective To observe and study the effects of dexmedetomidine on postoperative analgesia in patients by gynecological laparoscopic surgery. Methods 90 patients under general anesthesia before gynecologic laparoscopic surgery were randomly divided into three groups: control group (group C), dexmedetomidine with low concentration group (group D1) and dexmedetomidine with high concentration group (group D2), with 30 patient in each group. The intraoperative and postoperative consumption within 24 h of sufentanil and the number of effective pressure on the anal- gesic pump within 24 h were recorded. The visual analogue scale (VAS) analgesia score, Ramsay sedation score, adverse reactions and the satisfacto- ry degrees after surgery were recorded at different time point were recorded. Results There were significant difference in the number of effective pressure on the analgesic pump after surgery among the groups (P<0.05). In addition, the pairwise comparison of VAS analgesic scores and Ramsay scores at 1 h (T2) after surgery showed statistical differences. Furthermore, the VAS analgesic scores between every two groups have statistically sig- nificant difference at 8 h (T5) after surgery (P<0.05). The incidence of nausea and vomiting in group C was significantly higher than that in group D1 and D2, and the difference was statistically significant (P<0.05). Finally, compared to group C and D1, the patients of group D2 had significantly higher level of overall satisfaction (P<0.05). Conclusion Preemptive analgesia with dexmedetomidine can decrease adverse reactions, reduce VAS scores and enhance degree of satisfaction.

关 键 词：右美托咪定 超前镇痛 妇科腹腔镜 舒芬太尼 术后疼痛 

分 类 号：R47[医药卫生—护理学]