右美托咪定联合喷他佐辛预处理在腹腔镜妇科手术舒适化医疗中的应用  

Application of Dexmedetomidine Combined with Pentazocine Pretreatment in Laparoscopic Gynecological Surgery

作　　者：张欢楷[1] 黄小贤[1] 张隆盛[1] 杨铎 黄熙扬 林耿彬[1] 黄志良[1] 杨文科[1] ZHANG Huan-kai;HUANG Xiao-xian;ZHANG Long-sheng;YANG Duo;HUANG Xi-yang;LIN Geng-bin;HUANG Zhi-liang;YANG Wen-ke(Jieyang People's Hospital,Jieyang,Guangdong 522000)

机构地区：[1]揭阳市人民医院,广东揭阳522000

出　　处：《智慧健康》2021年第28期123-125,128,共4页Smart Healthcare

基　　金：广东省医学科学技术研究基金(项目编号:B2018001、A2021400);揭阳市卫生医疗类项目(项目编号:YLWS025)。

摘　　要：目的 本研究旨在探讨右美托咪定联合喷他佐辛预处理在腹腔镜妇科手术舒适化医疗中的应用效果。方法 选择2019年5月-2021年5月在揭阳市人民医院择期行妇科腹腔镜手术患者60例,随机分为D组和C组,每组30例。两组患者实施标准化气管插管静吸复合全身麻醉方案,D组患者在麻醉诱导前静脉注射右美托咪定0.5μg/kg和喷他佐辛30mg,C组患者静脉注射等量生理盐水。记录两组患者进入PACU麻醉复苏情况;记录两组患者苏醒期躁动情况;记录两组患者拔管后10min、拔管后30min、拔管后1h和拔管后2h的静息疼痛VAS评分;记录两组患者术后48h内不良反应发生情况。结果 D组患者舒芬太尼补救镇痛例数明显低于C组(P<0.05),两组患者自主呼吸恢复时间、拔管时间、PACU停留时间比较差异无统计学意义(P>0.05),D组患者苏醒期躁动发生率明显低于C组(P<0.05),D组患者拔管后10min、30min、1h、2h静息疼痛VAS评分明显低于C组(P<0.05)。结论 右美托咪定联合喷他佐辛预处理用于妇科腹腔镜舒适化医疗中,能降低苏醒期躁动发生率,提供术后早期镇痛,但不延长麻醉复苏时间。Objective The purpose of this study was to investigate the effect of dexmedetomidine combined with pentazocine pretreatment in laparoscopic gynecological surgery.Methods In this study,60 patients undergoing gynecological laparoscopic surgery in Jieyang People’s hospital were randomly divided into group D and group C,30 cases in each group.The two groups were treated with standardized endotracheal intubation combined with general anesthesia.Patients in group D were given dexmedetomidine 0.5μg/kg and pentazocine 30mg before anesthesia induction,while patients in group C were given the same amount of normal saline.The anesthesia and resuscitation in PACU were recorded;the restlessness of the two groups during the recovery period was recorded;the VAS scores of resting pain at 10min,30min,1h and 2h after extubation were recorded;the adverse reactions of the two groups within 48h after operation were recorded.Results The number of sufentanil rescue analgesia cases in group D was significantly lower than that in group C (P<0.05).There was no significant difference in spontaneous breathing recovery time,extubation time and PACU residence time between the two groups (P>0.05).The incidence of agitation in group D was significantly lower than that in group C (P<0.05).The VAS scores of resting pain in group D at 10min,30min,1h and 2h after extubation were significantly lower than those in group C (P<0.05).Conclusion Dexmedetomidine combined with pentazocine pretreatment can reduce the incidence of agitation during recovery period,and provide early postoperative analgesia,but it cannot prolong the recovery time.

关 键 词：右美托咪定 喷他佐辛 预处理 腹腔镜 妇科 舒适化医疗 

分 类 号：R614[医药卫生—麻醉学]