不同剂量右美托咪定在经尿道前列腺切除术后舒芬太尼智能化患者自控镇痛中的作用  

Effect of different doses of dexmedetomidine in sufentanil artificial intelligent patient-controlled analgesia after urethral prostatectomy

作　　者：于乐涛 石军[1] 尹玉良 Yu Letao;Shi Jun(Department of Anesthesiology,the First Peoples Hospital of Huainan City,Huainan 232007,China)

机构地区：[1]淮南市第一人民医院麻醉科,232007 [2]不详

出　　处：《国际泌尿系统杂志》2021年第4期593-596,共4页International Journal of Urology and Nephrology

摘　　要：目的探讨不同剂量右美托咪定在经尿道前列腺切除术后舒芬太尼智能化患者自控镇痛(Ai-PCA)中的作用。方法选取2019年1月至2020年6月在本院行经尿道前列腺切除术的良性前列腺增生患者%例为研究对象。采用随机数字表法分为A、B、C组及对照组,每组各24例。对照组给予舒芬太尼+阿扎司琼,A组给予0.5μg·(kg·d)^(-1)右美托咪定+舒芬太尼+阿扎司琼,B组给予1.0μg·(kg·d)^(-1)右美托咪定+舒芬太尼+阿扎司琼,C组给予1.5μg·(kg·d)^(-1)右美托咪定+舒芬太尼+阿扎司琼。观察四组患者疼痛程度、自控镇痛(PCA)泵使用率、右美托咪定剂量与舒芬太尼用量关系、不良反应及满意度。结果A、B、C组术后4、12、24及48 h疼痛评分均低于对照组(P<0.05)。A、B、C组PCA按压次数及舒芬太尼用量均低于对照组(P<0.05),且A、B、C组的PCA按压次数及舒芬太尼用量依次降低,三组组间比较,差异均有统计学意义(P<0.05)。不同剂量右美托咪定与舒芬太尼用量呈线性负相关(r=-0.953,P<0.05)。B组不良反应发生率低于对照组(P<0.05)。A、B、C组患者总满意度均高于对照组,且B组患者满意度最高(P>0.05)。结论对经尿道前列腺切除术后的患者予以1.0μg·(kg·d)^(-1)右美托咪定联合舒芬太尼治疗,可有效减少舒芬太尼总用量及不良反应,提高患者满意度,镇痛效果显著。Objective To investigate the effect of different doses of dexmedetomidine and sufentanilin artificial intelligent patient-controlled analgesia(Ai-PCA)after urethral prostatectomy.Methods Ninety-six patients with benign prostatic hyperplasia undergoing urethral prostatectomy in the hospital from January 2019 to June 2020 were selected and randomly divided into group A,B and C and control group,with 24 cases in each group.The control group was injected with sufentanil+aza-setron,group A was injected with 0.5μg·(μg·d)^(-1)dexmedetomidine+sufentanil+azasetron,group B was injected with 1.0μg·(kg·d)^(-1) dexmedetomidine+sufentanil+azasetron,and group C was g injected with 1.5·(μg·d)^(-1) dexmedetomidine+sufentanil+azasetron.The pain degree,patientcontrolled analgesia(PCA)usage rate,relationship between dexmedetomidine dose and sufentanil dose,adverse reactions and satisfaction of the four groups were observed.Results The pain scores of groups A,B and C were lower than those of the control group at 4,12,24 and 48 h after operation(P<0.05).In addition,the number of PCA pressing and the amount of sufentanil in groups A,B and C decreased successively,and the differences among the three groups were statistically sig-nificant(P<0.05).The number of PC A compressions and the dose of sufentanil in group A,R and C were lower than those in the control group(P<0.05),and the comparison between group A,B and C was significant(P<0.05).Different doses of dexmedetomidine and sufentanil dose were linearly negatively correlated(r=-0.953,P<0.05).The incidence of adverse reactions in group B was lower than that of the control group(P<0.05).The total satisfaction of group A,B and C was higher than that of control group,and group B had the highest satisfaction(P>0.05).Conclusions The 1.0(μg·kg·d)^(-1) dexmedetomidine combined with sufentanil can effectively reduce the total dosage and adverse reactions of sufentanil,improve patient satisfaction,and have a significant analgesic effect in patients after transurethral prostatectomy

关 键 词：前列腺增生 前列腺切除术 右美托咪啶 舒芬太尼 

分 类 号：R614[医药卫生—麻醉学]