右美托咪定不同给药方式用于胸腔镜肺癌根治术患者辅助麻醉的镇痛效果及安全性  

Analgesic effect and safety of different administration methods of dexmedetomidine for assisted anesthesia in patients undergoing thoracoscopic radical resection of lung cancer

作　　者：李圣平[1] 但家朋[1] 李德占[1] 肖锦亮 汪威廉 张鲲[1] LI Sheng-ping;DAN Jia-peng;LI De-zhan;XIAO Jin-liang;WANG Wei-lian;ZHANG Kun(Anesthesiology Department,Jingzhou City Center Hospital,Jingzhou 434020,China)

机构地区：[1]荆州市中心医院麻醉科,湖北荆州434020

出　　处：《实用药物与临床》2021年第9期832-835,共4页Practical Pharmacy and Clinical Remedies

基　　金：湖北省卫生和计划生育委员会科研项目(WJ2017 M242)。

摘　　要：目的探讨右美托咪定静脉输注和滴鼻给药对行胸腔镜肺癌根治术患者镇痛效果及安全性的影响。方法纳入我院2020年1月-2021年1月行胸腔镜肺癌根治术的150例患者,采用随机数字表法分为3组,每组50例。A组给予生理盐水滴鼻,B组给予右美托咪定静脉输注,C组给予右美托咪定滴鼻。比较三组基线资料、手术指标、术后镇痛效果、生命体征及不良反应发生情况。结果B组、C组术后首次追加舒芬太尼时间长于A组,术后24 h内舒芬太尼总量小于A组(P<0.05)。B组用药后10 min、拔管时及拔管后5 min HR、SPB及DBP水平低于A组(P<0.05);C组拔管时及拔管后5 min HR、SPB及DBP水平显著低于A组(P<0.05);C组用药后10 min HR水平显著低于B组(P<0.05)。B组、C组呛咳、高血压及心动过速发生率低于A组,C组心动过缓发生率低于B组(P<0.05)。结论右美托咪定滴鼻给药用于行胸腔镜肺癌根治术患者可有效提高镇痛效果,改善麻醉安全性,优于静脉输注。Objective To explore the effect of intravenous infusion of dexmedetomidine and nasal drops on the analgesic effect and safety in patients undergoing thoracoscopic radical resection of lung cancer.Methods Totally 150 patients who underwent thoracoscopic radical resection of lung cancer from January 2020 to January 2021 in our hospital were included and divided into 3 groups by random number table method,with 50 cases in each group.Group A was given nasal drops of normal saline,group B was given intravenous infusion of dexmedetomidine,and group C was given nasal drops of dexmedetomidine.The baseline data,surgical indicators,postoperative analgesia effects,vital signs and adverse reactions were compared among the three groups.Results The first time of sufentanil addition in group B and group C was significantly longer than group A(P<0.05).The total amount of sufentanil in group B and group C within 24 hours after operation was significantly less than group A(P<0.05).The levels of HR,SPB and DBP at 10 min after medication,at extubation and 5 min after extubation of group B were significantly lower than group A(P<0.05).The levels of HR,SPB and DBP at extubation and 5 min after extubation were lower in group C than in group A(P<0.05).The levels of HR at 10 min after treatment of group C was significantly lower than group B(P<0.05).The incidences of cough,hypertension and tachycardia in group B and C were lower than group A,and the incidence of bradycardia in group C was lower than group B(P<0.05).Conclusion Intranasal administration of dexmedetomidine for patients undergoing thoracoscopic radical resection of lung cancer can effectively improve the analgesic effect,improve the safety of anesthesia,and is better than intravenous infusion.

关 键 词：右美托咪定 肺癌 手术 镇痛 安全性 

分 类 号：R614[医药卫生—麻醉学] R734.2[医药卫生—外科学]