氢吗啡酮复合右美托咪定在胸腹腔镜术后静脉镇痛中的应用  

Application of hydromorphone combined with dexmedetomidine in postoperative intravenous analgesia following laparoscopic or thoracoscopic surgery

作　　者：王玥 范东毅[1] 杨禄坤[1] WANG Yue;FAN Dong-yi;YANG Lu-kun(Department of Anesthesiology,the Fifth Affiliated Hospital of Sun Yat-sen University,Zhuhai GUANGDONG 519000,China)

机构地区：[1]中山大学附属第五医院麻醉科,广东珠海519000

出　　处：《中国新药与临床杂志》2021年第11期764-766,共3页Chinese Journal of New Drugs and Clinical Remedies

摘　　要：目的探讨氢吗啡酮复合右美托咪定用于胸腹腔镜术后静脉镇痛的有效性和安全性。方法回顾性分析全身麻醉胸腹腔镜手术后使用氢吗啡酮复合氟比洛芬酯或氢吗啡酮复合右美托咪定行患者自控静脉镇痛(PCIA)的患者资料,共纳入患者70例,右美托咪定组34例,氟比洛芬酯组36例。镇痛液配方右美托咪定组和氟比洛芬酯组分别为右美托咪定2μg·kg^(-1)或氟比洛芬酯3.0 mg·kg^(-1)复合氢吗啡酮0.12 mg·kg^(-1)和托烷司琼8.96 mg。评估2组术后疼痛视觉模拟量表(VAS)评分,记录PCIA有效按压次数和不良反应发生情况等。结果术后6 h、48 h,右美托咪定组VAS评分低于氟比洛芬酯组,差异均有显著意义(P <0.05);术后24 h,VAS评分和PCIA有效按压次数组间比较无显著差异(P> 0.05)。2组Ramsay镇静评分和术后恶心、呕吐、瘙痒等不良反应发生率比较,均无显著差异(P> 0.05)。结论氢吗啡酮复合右美托咪定用于胸腹腔镜PCIA能有效减轻患者术后疼痛,不良反应少。AIM To investigate the efficacy and safety of hydromorphone combined with dexmedetomidine for postoperative intravenous analgesia following laparoscopic or thoracoscopic surgery.METHODS To retrospectively review data of patients who received patient controlled intravenous analgesia(PCIA) after laparoscopic or thoracoscopic surgery under general anesthesia.A total of 70 patients were included.According to different combination drugs,all patients were divided into dexmedetomidine group(34 cases) and flurbiprofen axetil group(36 cases).Except hydromorphone 0.12 mg·kg^(-1) and tropisetron injection 8.96 mg,the patients in dexmedetomidine group were received dexmedetomidine 2 μg·kg^(-1) for PCIA,while flurbiprofen axetil 3.0 mg·kg^(-1) in flurbiprofen axetil group.The postoperative visual analogue scale(VAS) score of pain,effective number of PCIA compression and adverse reactions were observed.RESULTS The VAS scores at 6 h and 48 h in the dexmedetomidine group were lower than those in the flurbiprofen axetil group(P < 0.05).The VAS score at 24 h,Ramsay sedation score,effective number of PCIA compression and incidence of adverse reactions such as nausea,vomiting,itching had no significant differences(P > 0.05) between two groups.CONCLUSION Hydromorphone combined with dexmedetomidine for postoperative intravenous analgesia following laparoscopic or thoracoscopic surgery can effectively relieve postoperative pain and has less adverse reactions.

关 键 词：氢吗啡酮 右美托咪定 镇痛 病人控制 胸腔镜手术 腹腔镜手术 

分 类 号：R971[医药卫生—药品]