舒芬太尼复合右美托咪定用于宫颈癌根治术术后镇痛的效果观察
Effect of the sufentanil combined with dexmedetomidine on postoperative analgesia in cervical cancer patients with radical hysterectomy
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摘要: 目的:观察舒芬太尼复合右美托咪啶在宫颈癌根治术术后镇痛的效果。方法:选取ASAⅠ~Ⅱ级的择期宫颈癌根治术患者56例,随机分为观察组和对照组,对照组术后镇痛给予舒芬太尼 1.0 μg·kg-1·d-1,观察组术后镇痛给予舒芬太尼1.0 μg·kg-1·d-1+右美托咪定1.0 μg·kg-1·d-1,2组术后镇痛持续量2 ml/h,单次负荷剂量 2 ml,锁定时间15 min,总容量100 ml。采用疼痛视觉模拟(VAS)评分评价2组手术结束时(T1)及术后2 h(T2)、8 h(T3)、24 h(T4)与48 h(T5)疼痛程度和镇静评分标准(Ramsay)分级;记录导尿管不适、呕吐、恶心发生率和患者满意度。结果:2组术后各时点疼痛VAS评分均<4分,T2~T5时点观察组疼痛VAS评分显著低于对照组(P<0.01);T2~T5时点观察组Ramsay分级均明显低于对照组(P<0.01);观察组导尿管不适、恶心、呕吐发生率均低于对照组(P<0.05);观察组患者满意度高于对照组(P<0.05)。结论:舒芬太尼复合右美托咪啶适合在宫颈癌根治术后镇痛中使用,与单纯舒芬太尼相比较,术后镇痛效果更好,不良反应发生率更低,患者更为舒适。Abstract: Objective: To observe the effects of sufentanil combined with dexmedetomidine on postoperative analgesia in cervical cancer patients with radical hysterectomy.Methods: Fifty-six ASAⅠor Ⅱcervical cancer patients scheduled by radical hysterectomy were randomly divided into the observation group and control group(28 cases each group).At postoperative analgesia,the control group were treated with sufentanil for 1.0 μg·kg-1·d-1,the observation group were treated with sufentanil for 1.0 μg·kg-1·d-1 combined with dexmedetomidine for 1.0 μg·kg-1·d-1,the postoperative analgesia continuous perfusion amount for 2 ml/h,single bolus for 2 ml,lockout time for 15 min and total volume for 100 ml were implemented in two groups.The degree of pain and sedation grade in two groups were evaluated using visual analog scale(VAS) after operation(T1) and at 2(T2),8(T3),24(T4) and 48 hours(T5) after operation.The incidences of bladder discomfort,nausea and vomiting,and satisfaction of patients in two groups were recorded after operation.Results: The postoperative VAS scores in two groups in all time points were less than 4.The pain scores of the observation group at T2 to T5 were significantly lower than that of the control group(P<0.01).The Ramesay grades of the observation group at T2 to T5 were significantly lower than that of the control group(P<0.01).The incidences of bladder discomfort,nausea and vomiting in observation group were lower than those in control group(P<0.05),the satisfaction of patient in observation group were higher than that in control group(P<0.05).Conclusions: The postoperative analgesia effects of sufentanil combined with dexmedetomidine on radical hysterectomy are better than that of sufentanil,which is lower adverse reaction and more comfortable.
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Key words:
- cervical cancer radical surgery /
- sufentanil /
- dexmedetomidine /
- postoperative analgesia
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[1] Wright GD, Herzog TJ, Neugut AI, et al.Comparative effectiveness of minimally invasive and abdominal radical hysterectomy for cervical cancer[J].Gynecol Oncol, 2012, 127(1):7-11. [2] 闫建军, 李艳, 龚辉.罗哌卡因联合吗啡病人自控硬膜外镇痛用于经腹宫颈癌根治术后镇痛效果研究[J].陕西医学杂志, 2013, 42(7):818-820. [3] Inoue S, Kawakami T, Seo N.A comparison of morphine concentrations for patients-controlled epidural analgesia following gynecological surgery[J].Minerva Anestesiol, 2009, 75(9):498-503. [4] Chen LM, Weinberg VK, Chen C, et al.Perioperative outcomes comparing patient controlled epidural versus intravenous analgesia in gynecologic oncology surgery[J].Gynecol Oncol, 2009, 115(3):357-361. [5] Lee K, Yoo BH, Yon JH, et al.General anesthesia versus monitored anesthetic care with dexmedetomidine for closed reduction of nasal bone fracture[J].Korean J Anesthesiol, 2013, 65(3):209-214. [6] 王克民, 孙艳红, 侯永强, 等.盐酸右美托咪定用于重症监护患者镇静镇痛的临床观察[J].河南科技大学学报:医学版, 2011, 29(4):267-268. [7] Prasad SR, Simha PP, Jagadeesh AM.Comparative study between dexmedetomidine and fentanyl for sedation during mechanical ventilation in post-operative paediatric cardiac surgical patients[J].Indian J Anaesth, 2012, 56(6):547-552. [8] Su F, Nicolson SC, Zuppa AF.A dose-response study of dexmedetomidine administered as the primary sedative in infants following open heart surgery[J].Pediatr Crit Care Med, 2013, 14(5):499-507. [9] Schenk MR, Putzier M, Kügler B, et al.Postoperative analgesia after major spine surgery:patient-controlled epidural analgesia versus patient-controlled intravenous analgesia[J].Anesth Analg, 2006, 103(5):1311-1317. [10] 姜莉莉, 侯彦深.不同浓度盐酸罗哌卡因用于宫颈癌根治患者术后镇痛疗效观察[J].新疆医学, 2012, 42(2):45-47. [11] 耿桂启, 李弘, 李宁, 等.不同镇痛方式对腹腔镜下宫颈癌根治术后血液流变学的影响[J].上海医学, 2012, 35(8):675-677. [12] Yamaguchi T, Kariya N, Miyagawa Y, et al.Combined epidural-spinal anesthesia for radical hysterectomy in a patient complicated with bronchiectasis diagnosed on preoperative anesthetic consultation[J].Masui, 2010, 59(10):1291-1293. [13] 李彦文, 欧阳文, 汪赛赢, 等.不同剂量右旋美托咪啶的镇静效应[J].临床麻醉学杂志, 2010, 26(7):580-582. [14] 夏芹, 叶旻, 汪汐, 等.右美托咪定复合芬太尼用于妇科手术后镇痛的疗效观察[J].临床麻醉学杂志, 2012, 28(8):815. [15] 陈超, 姜虹.舒芬太尼复合右旋美托咪定用于膝关节置换术后患者镇痛的效果观察[J].中国医药导报, 2013, 10(3):93-95. [16] Massad IM, Mohsen WA, Basha AS, et al.A balanced anesthesia with dexmedetomidine decreases postoperative nausea and vomiting after laparoscopic surgery[J].Saudi Med J, 2009, 30(12):1537-1541.
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