摘要
目的评价右美托咪啶对肺癌根治术后病人舒芬太尼自控静脉镇痛效果的影响。方法择期拟行肺癌根治术病人90例,采用随机数字表法,将病人随机分为三组(n=30),Ⅰ组于关胸前30min静脉注射生理盐水20mL,术后采用舒芬太尼进行PCIA(背景输注速率0.015μg·kg-1·h-1,PCA量0.025μg/kg,锁定时间10min);Ⅱ组于关胸前30min静脉注射右美托咪啶0.5μg/kg,术后PCIA同Ⅰ组;Ⅲ组术后采用舒芬太尼混合右美托咪啶进行PCIA(舒芬太尼背景输注速率0.015μg·kg-·1h-1,右美托咪啶背景输注速率0.05μg·kg-·1h-1,舒芬太尼PCA量0.025μg/kg,右美托咪啶PCA量0.08μg/kg,锁定时间10min)。记录麻醉前和输注右美托咪啶1h痛阈和耐痛阈;记录术后24h、48h内舒芬太尼用量、PCA总按压次数;记录术后镇痛期间恶心、呕吐、瘙痒、心动过缓、低血压、镇静过度和呼吸抑制等不良反应的发生情况。结果与Ⅰ组比较,Ⅲ组术后24h、48h舒芬太尼用量、PCA总按压次数降低,术后恶心、呕吐和瘙痒发生率降低(P<0.05);与Ⅱ组比较,Ⅲ组术后24h、48h舒芬太尼用量、PCA总按压次数降低,术后恶心、呕吐和瘙痒发生率降低(P<0.05);三组均未发生心动过缓、低血压、镇静过度和呼吸抑制。结论右美托咪啶混合舒芬太尼用于肺癌根治术后PCIA的效果优于单独应用舒芬太尼。
Objective To evaluate the impact of dexmedetomidine to the intravenous analgesic effect controlled by sufentanil of patients after radical surgery of lung cancer.Methods 90 patients with radical surgery of lung cancer were randomly divided into three groups（n = 30）.Group Ⅰ received intravenous injection of saline 20 mL at 30 min before chest closing;and postoperative sufentanil for PCIA（background infusion rate,0.015 μg·kg-1·h-1,PCA amount 0.025 μg/kg,locking time 10 min）;group II received intravenous injection of dexmedetomidine 0.5 μg/kg at 30 minutes before chest closing,and postoperative PCIA as the same of group Ⅰ;group III received postoperative sufentanil mixed with dexmedetomidine for PCIA（background infusion rate of sufentanil was 0.015 μg·kg-1·h-1,background infusion rate of dexmedetomidine was 0.05 μg·kg-1·h-1,PCA amount of sufentanil was 0.025 μg/kg,PCA amount of dexmedetomidine was 0.08 μg/kg,locking time 10 min）.The pain threshold and pain-tolerance threshold before anesthesia and 1 h after infusion of the dexmedetomidine were recorded;the amount of sufentanil and the times of total compressions and effectively pressing of PCA in the postoperative 24h and 48h were recorded;the occurrence of adverse reactions such as nausea,vomiting,itching,bradycardia,hypotension,sedation excessive and respiratory depression etc.during the postoperative analgesia were recorded.Results Compared with group Ⅰ,the amount of sufentanil,the times of total compressions and effectively pressing of PCA in the postoperative 24 h and 48 h of group Ⅲ reduced,with lower incidence of postoperative nausea,vomiting and itching（P 0.05）;compared with group Ⅱ,the amount of sufentanil and the times of total compressions and effectively pressing of PCA in the postoperative 48 h of group Ⅲ reduced,with lower incidence of postoperative nausea,vomiting and itching（P 0.05）;bradycardia,hypotension,sedation excessive and respiratory depression did not occur in these three groups.Conclusions The effect of PCIA after radical surgery of lung cancer used by dexmedetomidine mixed with sufentanil is better than sufentanil alone.
出处
《临床医学工程》
2012年第7期1094-1096,共3页
Clinical Medicine & Engineering
关键词
右美托咪啶
舒芬太尼
镇痛
病人控制
Dexmedetomidine
Sufentanil
Analgesia
Patient control
