右美托咪定复合舒芬太尼PCIA对结肠癌患者术后疼痛、舒适度的影响  

Effect of Dexmedetomidine and Sufentanil on Postoperative Patient-controlled Intravenous Analgesia in Patients with Colon Cancer

作　　者：杨小燕 朱国汉[2] 谭爱萍 YANG Xiao-yan;ZHU Guo-han;TAN Ai-ping(Department of Anesthesiology,the Peoples Hospital of Suzhou New District,Suzhou Jiangsu,215129)

机构地区：[1]苏州高新区人民医院麻醉科,江苏苏州215129 [2]苏州大学附属第一医院麻醉科,江苏苏州215006

出　　处：《医学临床研究》2020年第5期671-673,676,共4页Journal of Clinical Research

基　　金：中国高校医学期刊临床专项资金(11220060)。

摘　　要：[目的]探讨右美托咪定复合舒芬太尼在结肠癌腹腔镜手术患者术后静脉自控镇痛(PCIA)中的应用及对患者疼痛程度、舒适度的影响.[方法]选择本院实施腹腔镜结肠癌根治术患者104例,随机分为观察组和对照组,各52例;观察组术后采用右美托咪定复合舒芬太尼实施PCIA镇痛,对照组采用单药舒芬太尼PCIA.比较两组术后的疼痛程度、舒适度、血清皮质醇(Cor)、β-内啡肽(β-EP)、前列腺素E2(PGE2)、白细胞介素-6(IL-6)水平及不良反应.[结果]术后2~48 h,观察组患者对应时间点的VAS评分均低于对照组(P<0.05);观察组患者对应时间点的舒适度量表(BCS)评分均高于对照组(P<0.05);术后即刻,两组的血清Cor、β-EP、PGE2、IL-6水平相比较差异无显著性(P>0.05);术后24 h,观察组患者的血清Cor、β-EP、PGE2、IL-6水平均低于对照组(P<0.05);实施镇痛期间,观察组的不良反应总发生率为9.62%(5/52),低于对照组的21.15%(11/52),且差异有显著性(P<0.05).[结论]右美托咪定复合舒芬太尼在结肠癌腹腔镜手术患者术后PCIA中的应用对改善患者疼痛、舒适度体验具有更好的效果.[Objective]To investigate the effect of dexmedetomidine combined with sufentanil on pain and comfort of Patient-controlled Intravenous Analgesia(PCIA)in patients with colon cancer after laparoscopic surgery.[Methods]A total of 104 patients undergoing laparoscopic colon cancer radical mastectomy were selected from our hospital.They were randomly divided into the observation group and the control group with 52 cases in each.Patients in the observation group recieved dexmedetomidine combined with sufentanil for PCIA analgesia while patients in the control group only received single-agent sufentanil PCIA.Postoperative pain,comfort,serum Cor,(3-EP,PGE2,IL-6 and adverse reactions were compared between the two groups.[Results]The VAS scores of the observation group patients at the corresponding time points from 2 hours to 48 hours after surgery were lower than those of the control group(P<0.05).The BCS scores of the observation group patients at the corresponding time points were higher than those of the control group(P<0.05);At time immediately after surgery,there was no significant difference in serum Cor,p-EP,PGE2,and IL-6 levels between the two groups(P>0.05),while 24 hours after surgery,the levels of serum Cor,p-EP,PGE2,and IL-6 in the observation group were lower than those in the control group(P<0.05).During the implementation of analgesia,the incidence of adverse reactions in the observation group was 9.62%which was lower than that in the control group 21.15%(P<0.05).[Conclusion]The application of PCIA with both dexmedetomidine and sufentanil in patients with colon cancer after laparoscopic surgery has a better effect on improving patients’pain and comfort experience.

关 键 词：结肠肿瘤 芬太尼 右美托咪定 

分 类 号：R735.35[医药卫生—肿瘤]