摘要
目的探讨右美托咪定联合布托啡诺对乳腺癌改良根治术术后镇痛的影响。方法选择择期乳腺癌改良根治术患者80例,随机分为2组:DB组和S组各40例。两组均在全麻下行乳腺癌改良根治术,术后均采用静脉自控镇痛,DB组采用右美托咪定1.0μg/kg+布托啡诺10 mg,S组舒芬太尼100μg。记录术后2 h(t_0)、6 h(t_1)、12 h(t_2)、24 h(t_3)、48 h(t_4)的静息VAS评分、Ramsay镇静评分。记录术后48 h内镇痛泵按压次数及恶心呕吐、呼吸抑制等不良反应发生情况。结果与S组比较,DB组患者t_1~t_3时VAS评分明显降低(P<0.05),Ramsay评分明显升高(P<0.05),患者术后48 h内恶心呕吐、呼吸抑制发生率明显降低(P<0.05),镇痛泵有效按压次数明显降低(P<0.05)。结论乳腺癌改良根治术采用右美托咪定联合布托啡诺进行静脉镇痛,镇痛、镇静效果优于舒芬太尼单独应用,且可降低恶心呕吐、呼吸抑制发生率。
Objective To investigate the effect of dexmedetomidine combined with butorphanol on postoperative analgesia after modified radical mastectomy. Methods 80 patients undergoing modified radical mastectomy were randomly divided into 2 groups： group DB and group S,40 cases in each group. The two groups were treated with modified radical mastectomy under general anesthesia. PCIA was used after surgery. The drugs were as follows： group DB was dexmedetomidine1 μg/kg ＋ butorphanol 10 mg,and group S was sufentanil 100 μg. Resting VAS score and Ramsay sedation score were recorded at 2,6,12,24,48 h after operation. The press times of the analgesic pump within 48 h after the operation and the nausea and vomiting,respiratory depression and other adverse reactions were record. Results Compared with the group S,in group DB at t1-t3 time the VAS score of the patients was significantly lower（P〈0. 05）,and the Ramsay score was significantly increased（P〈0. 05）. The incidence of nausea and vomiting and respiratory depression decreased significantly（P〈0. 05）and the numbers of effective compressions in the analgesia pump within 48 h after operation decreased significantly（P〈0. 05）. Conclusion The analgesic sedative effect of dexmedetomidine combined with butorphanol on postoperative analgesia after modified radical mastectomy is better than sufentanil alone,and reduces the incidence of nausea,vomiting and respiratory depression.
作者
蔡松波
胡英东
刘晓宁
徐永庆
CAI Songbo;HU Yingdong;LIU Xiaoning;XU Yongqing(Huidong People＇ s Hospital,Huidong 516300,China)
出处
《现代医院》
2018年第8期1204-1206,共3页
Modern Hospitals
关键词
右美托咪定
布托啡诺
乳腺癌改良根治术
术后镇痛
Dexmedetonlidine
Butorphanol
Modified Radical Masteetomy,Postoperative Analgesia
