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右美托咪定在乳腺癌术后慢性疼痛中应用
引用本文:路喻清,冯阳阳,张向东,蔡惠. 右美托咪定在乳腺癌术后慢性疼痛中应用[J]. 临床军医杂志, 2016, 0(7): 701-703. DOI: 10.16680/j.1671-3826.2016.07.12
作者姓名:路喻清  冯阳阳  张向东  蔡惠
作者单位:1. 延安大学附属医院 麻醉科,陕西 延安,716000;2. 延安大学附属医院 骨科,陕西 延安,716000;3. 西安交通大学附属第一医院 麻醉科,陕西 西安 710061; 西安交通大学附属第一医院 胸外二科,陕西 西安 710061
基金项目:国家自然科学基金(81502295)
摘    要:
目的探讨右美托咪定在降低乳腺癌术后不良反应和慢性疼痛的发生率中的应用。方法采用随机、双盲、对照的研究方法,选择在全身麻醉下行乳房切除术及腋窝淋巴结清扫的患者60例,随机分为两组(n=30)。其中,实验组(D组)在诱导前10 min泵入右美托咪定1.0μg/kg,泵注10 min后改为维持量0.6μg/(kg·h);对照组(P组)泵注生理盐水。两组患者均采用舒芬太尼术后静脉自控镇痛。记录患者术后2、24、48 h疼痛的数字等级评分和不良反应发生情况。电话随访术后2~12个月期间疼痛的持续时间和强度。结果两组患者术后2、24、48 h疼痛评分比较,差异无统计学意义(P>0.05);但D组不良反应发生率显著小于P组(P<0.05)。D组术后2、4、6、12个月疼痛发生率明显低于P组(P<0.05)。结论乳腺癌术中应用右美托咪定可以提高患者舒适度,显著降低术后慢性疼痛的发生率。

关 键 词:右美托咪定  乳腺癌  不良反应  慢性疼痛

Application of dexmedetomidine in chronic pain after breast cancer surgery
Abstract:
Objective To investigate the effects of dexmedetomidine in reducing postoperative adverse reactions and the incidence of chronic pain of breast cancer patients with modified radical mastectomy. Methods A randomized,double blind,controlled study meth-od was used in present study. Totally 60 patients under general anesthesia for mastectomy and axillary lymph node dissection were ran-domly divided into two groups(n = 30). Patients in the experimental group(Group D)was infused with 1. 0 μg/ kg dexmedetomidine 10 minutes before induction,then maintained the amount of 0. 6 μg/(kg·h)of dexmedetomidine during sugery. Patients in the control group(Group P)was infused and maintained with physiological saline. All cases in two groups were treated with sufentanil for postop-erative intravenous analgesia. The digital grade score and adverse reaction were recorded in patients at 2,24,and 48 hours postopera-tively. Duration and intensity of pain during 2 to 12 months were followed up. Results There was no significant difference in pain scores between the two groups after 2,24 and 48 hours. However,the adverse reaction of Group D was significantly less than that of Group P(P < 0. 05). The incidence of chronic pain in 2,4,6,and 12 months after operation in Group D was significantly lower than in Group P(P < 0. 05). Conclusion Infusion of dexmedetomidine for breast cancer surgery can improve the comfort degree of patients, and significantly reduced the incidence of postoperative chronic pain.
Keywords:Dexmdetomidine  Breast cancer  Adverse reactions  Chronic pain
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