不同剂量右美托咪定联合舒芬太尼或布托啡诺对胃肠肿瘤患者术后镇痛的影响  

Effects of different doses of dexmedetomidine combined with sufentanil or butorphanol on postoperative analgesia in patients with gastrointestinal tumors

作　　者：徐方志 龚明富 谢智华 XU Fangzhi;GONG Mingfu;XIE Zhihua(Department of Anesthesiology,Luodian Hospital of Baoshan District,Shanghai 201908,China;Department of Hepatobiliary and Pancreatic Surgery,Shanghai East Hospital,Tongji University Affiliated East Hospital,Shanghai 256699,China)

机构地区：[1]上海市宝山区罗店医院麻醉科,上海201908 [2]上海市东方医院同济大学附属东方医院肝胆胰外科,上海256699

出　　处：《广州医科大学学报》2024年第5期26-29,共4页Academic Journal of Guangzhou Medical University

摘　　要：目的:探讨不同剂量右美托咪定联合舒芬太尼或布托啡诺对胃肠肿瘤患者术后镇痛的影响。方法:收集2021年10月至2023年10月上海市宝山区罗店医院收治的胃肠肿瘤患者120例,随机数字表法分为4组,每组30例。4组分别采用不同的术后静脉自控镇痛(PCIA)方案:A组为1.5μg/kg右美托咪定联合布托啡诺10 mg,B组为2.0μg/kg右美托咪定联合布托啡诺10 mg,C组为1.5μg/kg右美托咪定联合舒芬太尼100μg,D组为2.0μg/kg右美托咪定联合舒芬太尼100μg。比较4组镇痛效果、术后恢复情况及不良反应。结果:术后6、12、24、48、72 h,B组视觉模拟评分(VAS)逐渐降低,且明显低于同时点其他3组(均P<0.05)。与术后6 h比较,术后24、48、72 h时A组、C组、D组VAS评分均明显降低(均P<0.05)。B组术后肛门排气时间、术后镇痛泵按压次数均明显低于其余3组,D组术后镇痛泵按压次数明显低于A组、C组(均P<0.05)。4组不良反应发生率比较,差异无统计学意义(均P>0.05)。结论:术后高剂量右美托咪定联合布托啡诺静脉自控镇痛具有较好的临床效果,值得推广。Objective:To investigate the effect of different doses of dexmedetomidine combined with sufentanil or butorphanol on postoperative analgesia in patients with gastrointestinal tumors.Methods:A total of 120 patients with gastrointestinal tumors admitted to Luodian Hospital of Baoshan District,Shanghai from October 2021 to October 2023 were collected and divided into 4 groups by random number table method,with 30 cases in each group.Four groups were treated with different postoperative patient‑controlled intravenous analgesia(PCIA)regimens:group A was 1.5μg/kg dexmedetomidine combined with butorphanol 10 mg,group B was 2.0μg/kg dexmedetomidine combined with butorphanol 10 mg,group C was 1.5μg/kg dexmedetomidine combined with sufentanil 100μg,group D was 2.0μg/kg dexmedetomidine combined with sufentanil 100μg.The analgesic effect,postoperative recovery and adverse reactions of the four groups were compared.Results:At 6,12,24,48 and 72 h after operation,the visual analogue scale(VAS)score of group B was gradually decreased,which was significantly lower than those of the other three groups at the same time point(all P<0.05).Compared with 6 h after operation,the VAS scores of group A,group C and group D were significantly decreased at 24,48 and 72 h after operation(all P<0.05).The postoperative anal exhaust time and postoperative analgesia pump pressing times in group B were significantly lower than those in the other three groups,and the postoperative analgesia pump pressing times in group D were significantly lower than those in group A and group C(all P<0.05).There was no significant difference in the incidence of adverse reactions among the four groups(all P>0.05).Conclusion:Postoperative high‑dose dexmedetomidine combined with butorphanol intravenous patient‑controlled analgesia has a good clinical effect and which is worthy of popularizing.

关 键 词：胃肠肿瘤 右美托咪定 舒芬太尼 布托啡诺 镇痛 病人控制 

分 类 号：R614[医药卫生—麻醉学]