【摘要】 目的评估不同剂量右美托咪定(Dex)在根治性结肠癌切除术后自控镇痛中的有效性与安全性。方法选取全麻下根治性结肠癌切除术患者90例,用随机数字表法分为低剂量Dex组(LD组)、中剂量Dex组(MD组)和高剂量Dex组(HD组)。患者术后均使用静脉内自控镇痛(PCIA),LD组:舒芬太尼2μg/kg+Dex 2μg/kg, MD组:舒芬太尼2μg/kg+Dex 3μg/kg, HD组:舒芬太尼2μg/kg+Dex 4μg/kg。记录患者术后6h(T1),12h(T2),24h(T3),36h(T4) 4个时间点受试者呼吸循环参数、VAS及Ramsay评分、PCIA使用次数、不良反应和患者满意度等。结果 (1)在所有观察点HD组平均动脉压低于LD组、MD组,差异有统计学意义(P<0.05)。除T1观察点外MD组、HD组心率均比LD组低,差异有统计学意义(P<0.05)。(2)在T2,T3,T4观察点MD组VAS评分比LD组低。在所有观察点HD组VAS评分与LD组、MD组比较差异有统计学意义(P<0.05)。(3)在T1,T2,T3观察点HD组Ramsay评分比LD组高,差异有统计学意义(P<0.05)。(4)患者36h内PCIA使用次数中,HD组最少,LD组最多,差异有统计学意义(P<0.05)。MD组患者不良反应发生率最低且满意度最高。结论舒芬太尼2μg/kg联合Dex 3μg/kg在根治性结肠癌切除术后能达到令人满意的镇痛效果。更多还原

【Abstract】 Objective To evaluate the efficacy and safety of different dosages of Dexmedetomidine in patient-controlled analgesia after radical resection of colon cancer.Methods A total of 90 patients undergoing radical resection of colon cancer under general anesthesia were selected.The patients were divided into LD group(low dose dexmedetomidine group),MD group(middle dose dexmedetomidine group) and HD group(high dose dexmedetomidine group).All patients were treated with intravenous patient-controlled analgesia(PCIA).PCIA analgesic drugs were as follows: LD group: Sufentanil 2μg/kg+Dexmedetomidine 2μg/kg, MD group: Sufentanil 2μg/kg+Dexmedetomidine 3μg/kg, HD group: Sufentanil 2μg/kg+Dexmedetomidine 4μg/kg.Respiratory parameters, VAS and Ramsay scores, patient satisfaction, frequency of PCIA use and adverse reactions were recorded at 6 h(T1),12 h(T2),24 h(T3) and 36 h(T4) postoperatively.Results(1)The mean arterial pressure in HD group was significantly lower than that in LD group and MD group at all observation points(P<0.05).The heart rate of MD group and HD group was lower than that of LD group except T1 observation point(P<0.05).(2)The VAS scores of MD group were lower than that of LD group at T2,T3 and T4 observation points.The VAS scores of HD group were significantly higher than those of LD Group and MD Group(P<0.05).(3) At T1,T2 and T3 observation points, the Ramsay score of HD group was higher than that of LD group, the difference was statistically significant(P<0.05).(4)The frequency of PCIA use within 36 hours was the lowest in HD group and the most in LD group, the difference was statistically significant(P<0.05).MD group had the lowest incidence of adverse reactions and the highest satisfaction.Conclusion Sufentanil 2μg/kg combined with Dex 3μg/kg can achieve satisfactory pain control after radical resection of colon cancer.更多还原