右美托咪定与利多卡因对腹腔镜结直肠手术全身麻醉患者的辅助镇痛效果  

Effect of dexmedetomidine combined with lidocaine as an adjuvant to general anesthesia for laparoscopic colorectal surgery

作　　者：李丰[1] 刘远征 Li Feng;Liu Yuanzheng(Department of OperationⅡ,Nanyang Central Hospital,Nanyang 473000,China)

机构地区：[1]南阳市中心医院手术二部,南阳473000

出　　处：《中国实用医刊》2024年第18期37-40,共4页Chinese Journal of Practical Medicine

摘　　要：目的分析右美托咪定与利多卡因对腹腔镜结直肠手术全身麻醉患者的辅助镇痛效果。方法队列研究。抽取2022年6月至2023年6月南阳市中心医院收治的80例接受腹腔镜结直肠手术患者,按随机数字表法分为对照组与观察组,每组40例。两组术后均观察48 h。对照组采取全身麻醉,观察组采取右美托咪定联合利多卡因用于全身麻醉辅助镇痛。比较两组患者术后6、12、24、36 h疼痛程度[视觉模拟评分法(VAS)评分],比较两组术后12、24、36、48 h自控阵痛次数,比较两组患者术后36、48 h术后肠胃功能[进食-恶心-呕吐-查体-症状持续时间评分系统(I-FEED)评分],比较两组患者术后康复情况。结果术后6、12、24、36 h,观察组VAS评分均低于对照组(P均<0.05)。术后12、24、36、48 h,观察组患者自控镇痛次数均低于对照组(P均<0.05)。术后36、48 h,两组患者I-FEED评分较术后24 h逐渐降低,且观察组I-FEED评分均低于对照组(P均<0.05)。观察组术后首次排气、首次排便、首次饮食、住院时间均短于对照组(P均<0.05)。结论右美托咪定与利多卡因对腹腔镜结直肠手术全身麻醉患者有减轻疼痛、减少患者自控镇痛次数、改善术后肠胃功能、加快术后恢复的作用。Objective To analyze the effect of dexmedetomidine combined with lidocaine as an adjuvant to general anesthesia for laparoscopic colorectal surgery.Methods A total of 80 patients who underwent laparoscopic colorectal surgery in Nanyang Central Hospital from June 2022 to June 2023 were selected for the cohort study.And they were divided into a control group and an observation group by random number table method,with 40 cases in each group.Both groups were observed for 48 hours after surgery.The control group received general anesthesia,while the observation group received general anesthesia assisted by dexmedetomidine and lidocaine.The 6-,12-,24-,and 36-hour postoperative pain level evaluated by visual analogue scale(VAS)score of the two groups were compared.The 12-,24-,36-and 48-hour postoperative frequency of self-controlled analgesia pump were compared between the two groups.The 36-and 48-hour postoperative gastrointestinal function evaluated by intake,feeling nauseated,emesis,physical exam,and duration of symptoms(I-FEED)scores were compared between the two groups.The postoperative recovery of the two groups were compared.Results At 6,12,24,and 36 hours after surgery,the VAS score of the observation group was lower than that of the control group(all P<0.05).At 12,24,36 and 48 hours after surgery,the frequency of self-controlled analgesia pump in the observation group was lower than that in the control group(all P<0.05).At 36 and 48 hours after surgery,the I-FEED scores of the two groups gradually decreased compared with 24-hour postoperative I-FEED scores(P<0.05);and 36-and 48-hour postoperative I-FEED scores of the observation group were lower than those of the control group(all P<0.05).The observation group required shorter time for first exhaust,first bowel movement,first diet,and hospital stay compared with the control group(P<0.05).Conclusions Dexmedetomidine combined with lidocaine can reduce pain,decrease frequency of self-controlled analgesia pump,improve postoperative gastrointestinal function,and acc

关 键 词：右美托咪定 利多卡因 结直肠手术 术后肠胃功能评分 视觉模拟评分法 自控阵痛 

分 类 号：R614[医药卫生—麻醉学]