摘要
目的观察右美托咪定联合舒芬太尼应用于肺叶切除患者术后48h患者静脉自控镇痛（patientcontrolledintravenousanalgesia，PCIA）的效果。方法80例患者采用随机数字表法分为两组，每组40例：对照组（A组）采用舒芬太尼0．04μg·kg-1．h-1，观察组（B组）采用舒芬太尼0．03μg·kg-1·h-1＋右美托咪定0．07μg·kg-1·h-1，术后皆经静脉持续48h泵注行自控镇痛。观察患者术后对应时间点疼痛视觉模拟评分（visualanaloguescale，VAS）、Ramsay镇静评分、副作用发生率，并进行统计学分析。结果A组、B组均能达到目标镇痛水平，各时间点VAS评分均〈4分。与A组比较，B组VAS评分在术后6、12h两个时间点降低[（0．8±0．9）分比（1．8±0．7）分、（0．7±0．7）分比（1．9±0．8）分]，差异有统计学意义（P〈0．05）；与A组比较，B组Ramsay评分在术后6、12h两个时间点增高[（3．5±0．4）分比（2．2±0．5）分、（3．3±0．6）分比（2．3±0．3）分]，差异有统计学意义（P〈0．05），均未出现镇静过度，Ramsay评分〈4分；与A组比较，B组躁动、寒战、恶心呕吐、头晕的发生率降低分别为0比5％、0比5％、0比25％、0比10％，差异有统计学意义（P〈0．05）；与A组比较，B组镇痛好评和差评分别为34例比26例、0例比4例，差异有统计学意义（P〈0．05）。结论右美托咪定（0．07μg·kg-1.h-1）可明显提高舒芬太尼应用于肺叶切除患者术后PCIA镇痛、镇静效果，并减少其用量，从而减少相关副作用的发生，增加患者满意度。
Objective To observe the effaciacy of patient-controlled intravenous analgesia （PCIA） using dexmedetomidine combined with sufentanil within postoperative 48 h in patients undergoing pulmonary lobectomy. Methods A total of eighty patients were enrolled in this study. The PCIA was set immediately after operation in group A （sufentanil 0.04 μg.kg-1.h-1） and group B （sufentanil 0.03 μg.kg-1.h-1 combined with dexmedetomidine 0.07 μg.kg-1.h-1）（n=40）. The preoperative and postoperative visual analogue scale （VAS） scores, Ramsay score and adverse events were recorded and analyzed. Results Both of group A and group B achieved targeted pain levels, with the VAS scores of less than 4 at all observed points. Compared with group A, the VAS score in group B was significantly reduced at 6 h after surgery[ （0.8±0.9） vs （1.8±0.7）, P〈0.05] and 12 h after surgery [（0.7±0.7） vs （1.9±0.8）, P〈0.05 ]. The Ramsay score in group B was significantly increased at 6 h after surgery [ （2.2±0.5） vs （3.5±0.4）, P〈0.05 ] and 12 h after surgery [（2.3±0.3） vs （3.3±0.6）, P〈0.05）. No severe sedation was found and the Ramsay score was below 4. The incidence of restlessness, chills, vomiting and dizziness was lower in group B （0, 0, 0, 0） than those in group A （5%, 5%, 25% and 10%, P〈0.05 ）. The numbers of positive and negative pain complains in group B were 34 and 0, while those in group A were 26 and 4. Conclusions In patients undergoing pulmonary lobectomy, dexmedetomidine combined with sufentanil for PCIA can achieve the better analgesic and sedate effects, reduce sufentanil consumption and improve satisfaction index compared with PCIA using sufentanil alone.
出处
《国际麻醉学与复苏杂志》
CAS
2015年第10期888-891,共4页
International Journal of Anesthesiology and Resuscitation
关键词
右美托咪定
舒芬太尼
术后自控镇痛
Dexmedetomidine
Sufentanil
Patient controlled intravenous analgesia
