右美托咪定复合舒芬太尼靶控镇痛对腹腔镜术后应激反应及睡眠质量的影响  

Effects of target-controlled analgesia with dexmedetomidine combined with sufentanil on stress response and sleep quality after laparoscopy

作　　者：苏晓颜 万兆星[1] 郭正轩[2] SU Xiaoyan;WAN Zhaoxing;GUO Zhengxuan(Anesthesiology Department,Anyang District Hospital,Puyang,Henan,China,455000;Department of Oncology,Anyang District Hospital,Puyang,Henan,China,455000)

机构地区：[1]河南省濮阳市安阳地区医院麻醉科,河南濮阳455000 [2]河南省濮阳市安阳地区医院肿瘤科,河南濮阳455000

出　　处：《分子诊断与治疗杂志》2023年第12期2134-2137,2146,共5页Journal of Molecular Diagnostics and Therapy

基　　金：河南省医学教育研究项目(Wjlx2020475)。

摘　　要：目的探讨右美托咪定复合舒芬太尼靶控镇痛对腹腔镜手术后应激反应及睡眠质量的影响。方法选择96例行腹腔镜手术患者,随机分为研究组及对照组,研究组给予右美托咪定复合舒芬太尼靶控镇痛,对照组给予舒芬太尼镇痛,比价两组患者舒芬太尼用量,镇痛及镇静效果、术后应激反应及睡眠质量。结果术后12 h、24 h、48 h研究组患者VAS评分低于对照组,差异有统计学意义(t=9.714,6.502,6.502,P<0.05),Ramsay评分研究组高于对照组,差异有统计学意义(t=2.719,5.462,4.294,P<0.05);研究组术后48 h舒芬太尼用量低于对照组,差异有统计学意义(t=4.916,P=0.002),研究组镇痛不良反应发生率低于对照组,差异有统计学意义(χ^(2)=7.940,P=0.005)。两组术前PSQI评分比较差异无统计学意义(t=0.174,P=0.669),术后48 h研究组PSQI评分低于对照组,差异有统计学意义(t=3.917,P=0.002),两组患者术前去甲肾上腺(NA)、肾上腺素(A)及HR及SBP水平比较,差异无统计学意义(t=1.074,0816,0.339,0.285,P<0.05),术后12 h、24 h、48 h研究组患者血清NA及A水平低于对照组,差异有统计学意义(12 h:t=3.719,3.412,P<0.05;24 h:t=4.497,3.812,P<0.05,48 h:t=4.716,5.202,P<0.05),HR及SBP低于对照组,差异有统计学意义(12 h:t=4.012,t=0.002,2.594,P<0.05;24 h t=2.794,2.146,P<0.05;72 h:t=2.179,2.162,P<0.05)。结论右美托咪定复合舒芬太尼靶控镇痛能够改善腹腔镜手术后镇痛及镇静效果,降低应激反应,维护心血管系统稳定,改善患者睡眠质量。Objective To investigate the effects of dexmedetomidine combined with sufentanil on stress response and sleep quality after laparoscopic surgery.Methods 96 patients who underwent laparoscopic surgery were randomly divided into the research group and the control group.Patients in the study group were give right holder microphones set target compound ShuShu fentanyl analgesia,patients in the control group were give right supporting micomposite sufentanil target controlled analgesia,fentanyl dosage,analgesic and sedative effect,the postoperative stress reaction and sleep quality were contrast between study and control group.Results VAS score was lower in the study group than that in the control group postoperative at 12 h,24 h,48 h after operation(t=9.714,6.502,6.502,P<0.05),Ramsay score=is higher in the study than that in the control group(t=2.719,5.462,4.294,P<0.05).The dosage of sufentanil was lower in the study group than that in the control group at 48 hours after the operation(t=4.916,P<0.05),and incidence of analgesic adverse reactions was lower in the study group than that in the control group(χ^(2)=7.940,P<0.05).PSQI score was no significant difference between two groups before operation(t=0.174,P<0.05),and was lower in the control group than that in the study group at 48 hours after operation(t=3.917,P<0.05).The level of NA,A,HR and SBP were no significant difference in two groups before operation(t=1.074,0816,0.339,0.285,P<0.05),and the level of NA and A was lower(12 h:t=3.719,3.412,P<0.05;24 h:t=4.497,3.812,P<0.05;48 h:t=4.716,5.202,P<0.05),the level of HR and SBP was lower in the study group than that inthe control group at 12 h,24 h,48 h after operation(12 h:t=4.012,2.594,P<0.05;24 h t=2.794,2.146,P<0.05;72 h:t=2.179,2.162,P<0.05).Conclusion Dexmedetomidine combined with fentanyl can improve the analgesic and sedative effects after laparoscopic surgery,reduce the stress response,maintain the stability of cardiovascular system,and improve the sleep quality of patients.

关 键 词：右美托咪定 舒芬太尼 靶控镇痛 腹腔镜手术 应激反应 睡眠质量 

分 类 号：R614[医药卫生—麻醉学]