右美托咪定复合布托啡诺结直肠癌根治术后镇痛对肠道功能恢复的影响  

作　　者：李慧 韩玲娟 

机构地区：[1]浙江省绍兴市上虞区中医医院,312300

出　　处：《浙江临床医学》2025年第1期124-126,共3页Zhejiang Clinical Medical Journal

摘　　要：目的 探讨右美托咪定复合布托啡诺结直肠癌根治术后镇痛对肠道功能恢复的影响。方法 选取2022年9月至2023年9月择期在全身麻醉腹腔镜下行结直肠癌根治术的患者60例。随机分为布托啡诺组(B组)及布托啡诺+右美托咪定组(DB组)进行术后静脉自控镇痛,每组各30例。观察两组炎性细胞因子、二胺氧化酶(DAO)活性、D-乳酸浓度、内毒素(LPS)、疼痛视觉模拟评分(VAS)、胃肠道功能恢复及不良反应发生情况。结果 DB组术后12 h、48 h、72 h TNF-α、hs-CRP、IL-6及IL-8、DAO、D-乳酸及LPS低于B组,差异有统计学意义(P<0.05);DB组术后6 h、12 h、24 h、48 h、72 h VAS低于B组,差异有统计学意义(P<0.05);DB组胃肠道功能恢复时间短于B组,不良反应率低于B组,差异有统计学意义(P<0.05)。结论 结直肠癌根治术后镇痛应用右美托咪定复合布托啡诺,有效降低炎性反应及疼痛程度,减轻肠道屏障功能损害,加速胃肠道功能恢复,药物不良反应更少,促进机体康复。Objective To investigate the impact of dexmedetomidine combined with butorphanol on postoperative pain relief and intestinal function recovery after radical resection of colorectal cancer.Methods Sixty patients scheduled for elective laparoscopic radical resection of colorectal cancer under general anesthesia from September 2022 to September 2023 were selected.They were randomly divided into a butorphanol group(Group B)and a butorphanol combined with dexmedetomidine group(Group DB)for postoperative patient-controlled intravenous analgesia,with 30 patients in each group.The levels of inflammatory cytokines,diamine oxidase(DAO)activity,D-lactate concentration,endotoxin(LPS),visual analog scale(VAS)scores for pain,gastrointestinal function recovery,and adverse reactions were detected in both groups.Results At 12,48,and 72 hours after surgery,the levels of TNF-α,hs-CRP,IL-6,IL-8,DAO,D-lactate,and LPS were significantly lower in Group DB compared to Group B(P<0.05).At 6,12,24,48,and 72 hours after surgery,the VAS scores were significantly lower in Group DB compared to Group B(P<0.05).The recovery time of gastrointestinal function in Group DB was shorter than that in Group B,and the incidence of adverse reactions was lower,with statistically significant differences(P<0.05).Conclusion The application of dexmedetomidine combined with butorphanol for postoperative pain relief after radical resection of colorectal cancer effectively reduces inflammatory response and pain levels,alleviates intestinal barrier function damage,accelerates gastrointestinal function recovery,which has fewer adverse drug reactions,and promotes body recovery.

关 键 词：右美托咪定 布托啡诺 手术后镇痛 肠道功能 

分 类 号：R614[医药卫生—麻醉学] R735.34[医药卫生—外科学]