摘要
目的探究右美托咪定和丙泊酚联合芬太尼对晚期子宫颈癌癌痛患者植入式鞘内给药镇痛效果及安全性比较。方法回顾性选取2017年2月至2020年4月防城港市第一人民医院收治的晚期子宫颈癌癌痛患者患者100例。根据治疗方法不同分为A组(丙泊酚联合芬太尼,34例)、B组(右美托咪定联合芬太尼,33例)及C组(3种药物联合,33例)。观察3组手术情况,手术室时(T_(0))、手术开始15 min(T_(1))、手术开始60 min(T_(2))的平均动脉压、心率、血氧饱和度、视觉模拟评分,术后5、10、15 min的Ramsay评分及并发症情况。结果3组间满意度评分和芬太尼用量比较,差异有统计学意义(P<0.05);与A组比较,B组和C组满意度评分较高,C组高于B组,差异均有统计学意义(P<0.05);与A组比较,B组和C组芬太尼用量少,C组少于B组,差异均有统计学意义(P<0.05);3组间手术时间和苏醒时间比较,差异均无统计意义(P>0.05)。3组组内和组间T_(0)、T_(1)、T_(2)时平均动脉压、心率、血氧饱和度及视觉模拟评分比较,差异均有统计学意义(P<0.001);与A组比较,T_(1)、T_(2)时B组和C组平均动脉压、血氧饱和度较高,C组高于B组,差异均有统计学意义(P<0.05);与A组比较,T_(1)、T_(2)时B组和C组心率、视觉模拟评分较低,C组低于B组,差异均有统计学意义(P<0.05)。3组组内和组间术后5、10、15 min的Ramsay评分比较,差异均有统计学意义(P<0.001);与A组比较,B组和C组Ramsay评分较低,C组低于B组,差异均有统计学意义(P<0.05)。3组间低血压、呼吸抑制、恶心呕吐及口干等比例比较,差异均无统计学意义(P<0.05)。结论右美托咪定和丙泊酚联合芬太尼对晚期子宫颈癌癌痛患者植入式鞘内给药具有较好镇静、镇痛效果,3种药物联合可减少芬太尼用量,且不良反应较小,可为晚期子宫颈癌癌痛患者镇痛提供参考。
Objective To investigate the analgesic effect and safety of implanted intrathecal administration of dexmedetomidine and propofol combined with fentanyl in patients with advanced cervical cancer pain.Methods A total of 100 patients with advanced cervical cancer pain admitted to Fangchenggang First People's Hospital from February 2017 to April 2020 were retrospectively selected.According to different treatment methods,they were divided into group A(propofol combined with fentanyl,34 cases),group B(dexmedetomidine combined with fentanyl,33 cases),and group C(combination of the three,33 cases).Operation status,mean arterial pressure,heart rate,blood oxygen saturation,visual analog score in the operating room(T_(0)),15 minutes from the beginning of the operation(T_(1)),60 minutes from the beginning of the operation(T_(2)),Ramsay score at 5,10,15 min after operation and complications were observed in the three groups.Results There were statistically significant differences in satisfaction scores and fentanyl dosage among the three groups(P<0.05);The satisfaction scores of group B and C were higher than group A,group C was higher than group B,and the differences were statistically significant(P<0.05);The dosage of fentanyl in group B and group C was less than that in group A,and group C was less than group B,the difference was statistically significant(P<0.05);There was no statistically significant difference in operation time and wake-up time between the 3 groups(P>0.05).There were statistically significant differences in mean arterial pressure,heart rate,blood oxygen saturation and visual analogue score at T_(0),T_(1),and T_(2) within and between the three groups,the differences were statistically significant(P<0.001);The average arterial pressure and blood oxygen saturation in group B and C at T_(1),T_(2) were higher than those in group A,and group C were higher than those in group B,and the differences were statistically significant(P<0.05);the heart rate and visual analogue score in group B and C at T_(1) and T_(2) were lower than those in group A,and group C were lower than those in group B,the differences were statistically significant(P<0.05).There were statistically significant differences in the Ramsay scores at 5,10,and 15 minutes after the operation within and between the three groups(P<0.001);the Ramsay scores in group B and C were lower than those in group A,and group C were lower than those in group B,the differences were statistically significant(P<0.05).The proportions of hypotension,respiratory depression,nausea and vomiting and dry mouth were not statistically significant among the three groups(P>0.05).Conclusion Dexmedetomidine and propofol combined with fentanyl have a good sedative and analgesic effect in patients with advanced cervical cancer pain.The three combinations can reduce the fentanyl dosage with less adverse effects,which can provide information for pain relief in patients with advanced cervical cancer pain.
作者
刘永琳
何世桂
秦书琴
LIU Yong-lin;HE Shi-gui;QIN Shu-qin(Department of Anesthesiology,Fangchenggang First People's Hospital,Fangchenggang Guangxi 538021,China)
出处
《临床和实验医学杂志》
2021年第14期1524-1528,共5页
Journal of Clinical and Experimental Medicine
基金
广西壮族自治区卫生健康委员会自筹经费科研课题(编号:Z20190407)。
关键词
晚期子宫颈癌
癌痛
右美托咪定
丙泊酚
芬太尼
植入式鞘内给药
Advanced cervical cancer
Cancer pain
Dexmedetomidine
Propofol
Fentanyl
Implantable intrathecal administration
