右美托咪定复合舒芬太尼用于腹腔镜下子宫全切术后镇痛的临床价值  

Clinical value of dexmedetomidine combined with sufentanil in postoperative analgesia for patients undergoing laparoscopic total hysterectomy

作　　者：殷梦兰 刘丹红 王贝 YIN Menglan;LIU Danhong;WANG Bei(Department of Anesthesiology,ChangzhouWujin Hospital of Traditional Chinese Medicine,Changzhou 213161,China)

机构地区：[1]常州市武进中医医院麻醉科,江苏常州213161

出　　处：《麻醉安全与质控》2024年第6期313-317,共5页Perioperative Safety and Quality Assurance

基　　金：常州市武进区科技计划项目(WS201932)。

摘　　要：目的分析右美托咪定复合舒芬太尼在腹腔镜下子宫全切术后镇痛的临床价值。方法选取2019-02/2022-03期间常州市武进中医医院行腹腔镜下子宫全切术的患者80例为研究对象,年龄40~60岁,ASA分级Ⅰ或Ⅱ。采用随机数字表法将患者分为舒芬太尼组(n=40)和右美托咪定复合舒芬太尼组(n=40)。舒芬太尼组术后应用舒芬太尼镇痛,右美托咪定复合舒芬太尼组术后应用右美托咪定复合舒芬太尼镇痛,对两组干预结果进行评价。对两组患者疼痛评分、镇静评分、自控镇痛泵按压次数、术后48 h血清皮质醇(Cor)、脑源性神经因子(BDNF)、白介素6(IL-6)、不良反应发生率进行评价。结果右美托咪定复合舒芬太尼组术后2 h、6 h、12 h和24 h的疼痛数字评分法(NRS)(2.98±0.34、2.01±0.22、1.67±0.14、1.75±0.16)均低于舒芬太尼组(3.59±0.57、2.63±0.34、2.26±0.27、2.19±0.25)(P<0.05);右美托咪定复合舒芬太尼组术后2 h、6 h、12 h和24 h的Ramsay镇静评分(3.09±0.39、2.16±0.27、1.87±0.18、1.81±0.17)均低于舒芬太尼组(3.74±0.61、2.68±0.39、2.32±0.29、2.22±0.28)(P<0.05);右美托咪定复合舒芬太尼组术后24 h、48 h的患者自控镇痛(PCA)按压次数(8.96±1.56、10.75±1.72)均少于舒芬太尼组(12.34±1.93、18.52±2.13)(P<0.05);右美托咪定复合舒芬太尼组术后48 h各项血清学指标(Cor:118.47±13.28μg/L,BDNF:3.72±0.53μg/L,IL-6:8.41±0.76 ng/L)均低于舒芬太尼组(Cor:202.75±16.29,BDNF:4.47±0.75,IL-6:11.92±1.25)(P<0.05);右美托咪定复合舒芬太尼组不良反应发生率(5.0%)低于舒芬太尼组(22.5%)(P<0.05)。结论右美托咪定复合舒芬太尼用于腹腔镜下子宫全切术后镇痛的价值较高,可提供良好镇痛、镇静效应,还可减轻围术期应激反应及炎症反应,减少术后不良反应,值得应用。Objective To analyze the clinical value of dexmedetomidine combined with sufentanil in postoperative analgesia for patients undergoding laparoscopic total hysterectomy.Methods A total of 80 patients,aged 40-60 years,ASA I or II,undergoing laparoscopic total hysterectomy in Changzhou Wujin Hospital of Traditional Chinese Medicine from February 2019 to March 2022 were enrolled.The patients were randomly divided into sufentanil group(n=40)and dexmedetomidine combined with sufentanil group(n=40).The sufentanil group was treated with sufentanil for analgesia after surgery,and the dexmedetomidine combined with sufentanil group was treated with dexmedetomidine combined with sufentanil for analgesia after surgery,and the pain score,sedation score,number of self-controlled analgesic pump compressions,serum cortisol(Cortisol),brain-derived neurotrophic factor(BDNF),interleukin-6(IL-6)and the incidence of adverse reactions were evaluated.Results The numerical rating scales(NRS)at 2 h,6 h,12 h and 24 h postoperatively were 2.98±0.34,2.01±0.22,1.67±0.14 and 1.75±0.16 in the dexmedetomidine combined with sufentanil group,which were lower than those in the sufentanil group(3.59±0.57,2.63±0.34,2.26±0.27,2.19±0.25)(P<0.05);the Ramsay sedation scores at 2 h,6 h,12 h and 24 h postoperatively were 3.09±0.39,2.16±0.27,1.87±0.18 and 1.81±0.17 in the dexmedetomidine combined with sufentanil group,which were lower than those in the sufentanil group(3.74±0.61,2.68±0.39,2.32±0.29,2.22±0.28)(P<0.05);the number of PCA compressions at 24 h and 48 h in the dexmedetomidine combined with sufentanil group were 8.96±1.56 and 10.75±1.72,which were lower than those in the sufentanil group(12.34±1.93,18.52±2.13)(P<0.05);the serological indexes of the dexmedetomidine combined with sufentanil group at 48 h after surgery(Cor:118.47±13.28μg/L,BDNF:3.72±0.53μg/L,IL-6:8.41±0.76 ng/L)were lower than those in the sufentanil group(Cor:202.75±16.29,BDNF:4.47±0.75,IL-6:11.92±1.25)(P<0.05).The incidence of adverse reactions in the de

关 键 词：右美托咪定 舒芬太尼 腹腔镜 子宫全切术 

分 类 号：R614[医药卫生—麻醉学]