舒芬太尼复合右美托咪定妇科腔镜手术术后镇痛效果观察.pdf

#690#临床麻醉学杂志2011年7月第27卷第7期JClinAnesthesiol,July2011,Vol.27,No.7

#临床研究#
舒芬太尼复合右美托咪定妇科腔镜手术术后镇痛
效果观察

林莹陈彦青戴双波

=摘要>目的观察舒芬太尼复合右美托咪啶在妇科腔镜手术术后镇痛的效果。方法选择
ASAÑ或Ò级择期行妇科腔镜手术患者60例,随机均分三组:Ñ组术后镇痛给予舒芬太尼115
Lg#kg-1#d-1,Ò组舒芬太尼110Lg#kg-1#d-1,Ó组舒芬太尼110Lg#kg-1#d-1+右美托咪定110
Lg#kg-1#d-1。三组术后镇痛持续量2ml/h,单次负荷剂量2ml,锁定时间15min,总容量100ml。

采用疼痛VAS评分评价三组术毕(T1)及术后6h(T2)、12h(T3)、24h(T4)与48h(T5)疼痛程度及
各时段自控镇痛按压次数,记录不良反应发生率。结果三组术后各时点疼痛VAS评分均<4分,

T2~T5时Ò组疼痛VAS评分显著高于Ñ、Ó组(P<0105);0~6h、6~12h、12~24h时Ò组自控按
压次数明显多于Ñ、Ó组(P<0105)。Ñ组恶心呕吐发生率高于Ò、Ó组(P<0105)。结论右美托
咪定妇科腔镜手术术后镇痛可减少舒芬太尼使用量,同时降低其恶心呕吐的发生率,但心动过缓发
生率增高。
=关键词>右美托咪定;妇科腔镜手术;术后镇痛

Effectofsufentanilcombinedwithdexmedetomidineonpostoperativeanalgesiainpatientsundergoing
gynecologicallaparoscopicsurgeriesLINYing,CHENYan-qing,DAIShuang-bo.Departmentof
Anesthesiology,FujianProvincialHospital,Fuzhou350001,China
=Abstract>ObjectiveToobservetheeffectofsufentanlcombinedwithdexmedetomidineon
postoperativeanalgesiainpatientsundergoinggynecologicallaparoscopicsurgeries.MethodsSixty
patientswithASAphysicalstatusÑorÒundergoingelectivegynecologicallaparoscopicsurgeries
wererandomlydividedintothreegroupswith20each:groupÑreceivedsufentanil115Lg#kg-1#
d-1,groupÒreceivedsufentanil110Lg#kg-1#d-1,groupÓreceivedsufentanil110Lg#kg-1#d-1+
dexmedetomidine110Lg#kg-1#d-1.Theanalgesicpumpwassetinthethreegroupsasfollows:
continuousperfusionrate2ml/h,singlebolus2ml,lockouttime15min,totalvolume100ml.Pain

intensitywasassessedwithvisualanalogscale(VAS)attheimmediatetimeafteroperation(T1)and

6h(T2),12h(T3),24h(T4)and48h(T5)afteroperation.Thenumberofpatient-controlled
pressofthepumpandtheincidenceofsideeffectswererecorded.ResultsVASscoringsofthethree

groupsatallthetimepointswerelessthan4,butgroupÒatT2-T5displayedhigherpainintensity
thanthatofthegroupsÑandÓ(P<0105),andthenumberofself-controlledpressofthepumpin
groupÒwasmarkedlymorethangroupsÑandÓat0-6h,6-12h,12-24h(P<0105).The
incidenceofnauseaandvomitingingroupÑwashigherthangroupsÒandÓ(P<0105).Conclusion
Dexmedetomidinecanreducepostoper