右美托咪定复合舒芬太尼行静脉自控镇痛对喉部分切除患者预后的影响  

Effect of dexmedetomidine combined with sufentanil for conducting PCIA on prognosis in patients with partial laryngectomy

作　　者：高伟 高媛 杜海亮 杨岚[1] 宋珂珂 阳婷婷 沙保勇 高巍[1] GAO Wei;GAO Yuan;DU Hailiang;YANG Lan;SONG Keke;YANG Tingting;SHA Baoyong;GAO Wei(Department of Anesthesia and Surgery,First Affiliated Hospital of Xi′an Jiaotong University,Xi′an,Shannxi 710061,China;Institute of Basic Medical Science,Xi′an Medical University,Xi′an,Shaanxi 710021,China)

机构地区：[1]西安交通大学第一附属医院麻醉手术部,西安710061 [2]西安医学院基础医学部,西安710021

出　　处：《重庆医学》2021年第15期2639-2642,共4页Chongqing medicine

基　　金：陕西省创新人才推进计划—青年科技新星项目(2019KJXX-046);中央高校基本科研业务费(xjj2018262)。

摘　　要：目的探讨右美托咪定复合舒芬太尼行静脉自控镇痛(PCIA)对喉部分切除患者术后早期疼痛、心理状态及睡眠质量的影响。方法选取择期全身麻醉下行喉部分切除术患者60例,采用随机数字表法分为舒芬太尼组(S组)和舒芬太尼复合右美托咪定组(SD组),各30例。术毕行PCIA,S组给予舒芬太尼1.5μg/kg,SD组给予舒芬太尼1.5μg/kg+右美托咪定5μg/kg,两组背景输注速度均为2 mL/h,PCIA剂量每次1 mL,锁定时间15 min。分别记录术后4、8、12、24 h疼痛视觉模拟量表(VAS)评分,24 h内舒芬太尼使用量。于术前、术后第1、2、7天行焦虑自评量表(SAS)、抑郁自评量表(SDS)及阿森斯失眠量表(AIS)评分,记录术后相关并发症。结果两组患者各时间点VAS评分均低于4分。与S组比较,SD组术后各时间点VAS评分明显降低,24 h舒芬太尼使用量明显减少(P<0.05)。除术后第7天SAS评分,SD组术后第1、2、7天SAS、SDS及AIS评分均明显低于S组(P<0.05)。两组患者术后并发症发生率无明显差异(P>0.05)。结论右美托咪定复合舒芬太尼PCIA用于喉部分切除术后镇痛效果确切,能改善患者术后早期心理健康和术后睡眠质量,有利于患者恢复。Objective To investigate the effect of dexmedetomidine combined with sufentanil for conducting the patient-controlled intravenous analgesia(PCIA)on postoperative early pain,mental state and sleep quality in patients with partial laryngectomy.Methods Sixty patients with elective partial laryngectomy under general anesthesia were selected and divided into the sufentanil group(group S)and sufentanil combined dexmedetomidine group(group SD)by using the random number table method,30 cases in each group.PCIA was performed at the end of the operation.Group S was given sufentanil 1.5μg/kg;group SD was given sufentanil 1.5μg/kg+dexmedetomidine 5μg/kg.The background infusion velocity of the two groups was 2 mL/h,the PCIA dose was 1 mL per time and the locking time was 15 min.The VAS scores at postoperative 4,8,12,24 h and sufentanil dosage within postoperative 24 h were recorded.The scoring of AIS,SAS and SDS were performed before operation and on postoperative 1,2,7 d.The postoperative related complications were recorded.Results The VAS scores at each time point in the two groups were lower than 4 points.Compared with group S,the VAS score at each postoperative time point,sufentanil dosage at postoperative 24 h in group SD were significantly decreased(P<0.05).The scores of SAS,SDS and AIS on postoperative 1,27 d in group SD were significantly lower than those in group S except for the SAS score on postoperative 7 d(P<0.05).There was no statistically significant difference in postoperative complications between the two groups(P>0.05).Conclusion Dexmedetomidine combined with sufentanil for conducting PCIA after partial laryngectomyhas definite efficacy,can improve the mental status and sleep quality in the early postoperative period,and is helpful to the recovery of the patients.

关 键 词：右美托咪定 喉部分切除术 失眠 焦虑 并发症 

分 类 号：R614[医药卫生—麻醉学]