摘要
目的观察布托啡诺联合右美托咪定对甲状腺癌手术患者术后镇痛的效果。方法采用随机数表法将136例接受甲状腺切除术患者分成2组,实验组(E组)和对照组(C组),每组68例。采用患者自控镇痛(PCIA)剂量+背景剂量模式,C组镇痛药物配方为布托啡诺10 mg,E组镇痛药物配方为布托啡诺10 mg+右美托咪定300μg,镇痛药物均使用0.9%氯化钠溶液稀释至100 mL。记录术后4、12、24、48 h的静息和活动VAS疼痛评分。记录术后48 h内补救镇痛次数。记录术后48 h内恶心、呕吐等不良反应的发生情况以及围手术期并发症、需要补救性疼痛药物的患者数量、疼痛药物等。结果与C组比较,E组术后4~24 h静息和活动VAS评分均明显降低,并且补救镇痛曲马多用量更少,术后3天内,每天的最大疼痛评分均更低(P<0.05)。E组患者在术后眩晕和恶心呕吐的发生率明显低于C组,差异有统计学意义(P<0.05);2组均无谵妄、呼吸抑制发生,尿潴留、瘙痒和住院天数差别无统计学意义(P>0.05)。结论布托啡诺联合右美托咪定对甲状腺癌手术患者术后镇痛效果良好,不良反应少,可以参考作为多模式镇痛方案之一。
Objective To observe the analgesic effect of butorphanol combined with dexmedetomidine on postoperative patients with thyroid cancer.Methods 136 patients with thyroidectomy were randomly divided into the experimental group(Group E)and the control group(Group C),68 cases in each group.The patient-controlled analgesia(PCIA)dose+background dose mode was used.The analgesic drug formula of group C was butorphanol 10mg,and that of group E was butorphanol 10mg+dexmedetomidine 300μg.The analgesic drugs were diluted to 100 ml with 0.9%sodium chloride solution.The VAS pain scores of rest and activity were recorded at 4,12,24 and 48 hours after operation.The times of rescue analgesia within 48 hours after operation were recorded.The incidence of nausea,vomiting and other adverse reactions within 48 hours after operation was recorded.Perioperative complications,the number of patients who need remedial pain drugs,pain drugs,etc.Results Compared with group C,the rest and activity VAS scores of group E were significantly lower at 4-24 h after operation,and the dosage of tramadol was less,and the daily maximum pain scores were lower within 3 days after operation(P<0.05).The incidence of vertigo and nausea and vomiting in group E was significantly lower than that in group C(P<0.05),no delirium and respiratory depression occurred,there was no significant difference in urinary retention,itching and length of stay(P>0.05).Conclusion Butorphanol combined with dextrometramidine has good analgesic effect and less adverse reactions in patients with thyroid cancer operation.It can be referred as one of the multi-mode analgesic schemes.
作者
孙婷
王震
赵晨璐
于道阳
李林
杨扬
SUN Ting;WANG Zhen;ZHAO Chenlu(Zhumadian Central Hospital,Zhumadian,463000)
出处
《实用癌症杂志》
2022年第1期74-76,共3页
The Practical Journal of Cancer
基金
2019年度河南省医学科技攻关计划联合共建项目(编号:LHGJ20190665)。
关键词
布托啡诺
右美托咪定
术后镇痛
甲状腺癌手术
Butorphanol
Dexmedetomidine
Postoperative Analgesia
Thyroid Cancer Surgery
