羟考酮联合右美托咪定用于腹腔镜下结肠癌根治术术后镇痛效果评价

目的：观察羟考酮联合右美托咪定用于腹腔镜下结肠癌根治术术后镇痛的有效性和安全性。方法：选择腹腔镜下结肠癌根治术术后使用静脉自控镇痛患者60例,采用信封法随机分为对照组和实验组（n=30）。对照组药物为0.5 mg·kg^-1羟考酮,实验组药物为0.5 mg·kg^-1羟考酮加2μg·kg^-1右美托咪定。2组药物均用生理盐水稀释至100 mL并装入镇痛泵,维持量为1 mL·h^-1,单次剂量为1.5 mL,锁定时间为10 min。记录2组患者在送麻醉后恢复室（T₁）及术后6（T₂）、12（T₃）、24（T₄）和48 h （T₅）时活动痛及静息痛的疼痛视觉模拟（VAS）评分、镇痛泵药物用量、镇痛急救措施次数及术后首次肛门排气时间;观察2组患者术后不良反应、生命体征及Ramsay镇静评分。结果：实验组患者T₂~T₅时活动痛及T₂~T₄时静息痛VAS评分明显低于对照组（活动痛：P_T2~T5=0.000;静息痛：P_T2=0.018,P_T3=0.001,P_T4=0.010）;实验组患者镇痛泵药物用量和紧急镇痛措施次数明显少于对照组（P=0.000;P=0.029）;实验组患者术后肛门排气时间明显早于对照组（P=0.030）;实验组患者恶心发生例数明显少于对照组（P=0.023）,2组患者术后48 h内其他不良反应发生率比较差异无统计学意义（P>0.05）。结论：羟考酮联合右美托咪定可以安全有效地应用于腹腔镜下结肠癌根治术术后镇痛。

Evaluation on postoperative analgesia efficacy of oxycodone combined with dexmedetomidine in patients underwent laparoscopic radical surgery of colon cancer

Objective:To evaluate the efficacy and safety of oxycodone combined with dexmedetomidine in the postoperative analgesia in the patients underwent laparoscopic radical surgery of colon cancer.Methods:Sixty colon cancer patients underwent laparoscopic radical surgery and recevied patient-controlled intravenous analgesia after operation were randomly divided into control group and experiment group (n=30)using The "Envelope Method". The patients in control group were given 0.5 mg·kg-1 oxycodone,and the patients in experiment group were given 0.5 mg·kg-1 oxycodone and 2 μg·kg-1 dexmedetomidine.The parameters of analgesic pump in two groups were set as follows:the continuous perfusion rate was 1 mL·h-1 ,the single bolus was 1.5 mL,the lock-out time was 10 min,and the total volume was 100 mL.The VAS scores of pain at rest and activity pain of the patients in two groups were evaluated at exiting the post anesthesia care unit (T1 ),and at 6 h (T2 ),12 h (T3 ),24 h (T4 )and 48 h (T5 )after operation.The dose of analgesic drugs used,times of emergent rescue analgesia and anus exhaust time after operation of the patients in two groups were recorded;the postoperative adverse responses,vital signs and Ramsay scores of the patients in two groups were observed.Results:The VAS scores of activity pain at T2 -T5 and pain at rest at T2 -T4 of the patients in experiment group (P T2-T5 =0.000;P T2 =0.018,P T3 =0.001,P T4 =0.010)were lower than those in control group;the doses of analgesic drugs used and times of emergent rescue analgesia of the patients in experiment group were significantly lower than those in control group (P =0.000,P =0.029);the anus exhaust time after operation was significantly earlier than that in control group (P =0.030);the cases of nausea of the patients in experiment group were significantly lower than that in control group (P =0.023), and there were no significantly differences in the other various adverse effects of the patients between two groups (P >0.05).Conclusion: Oxycodone combined with dexmedetomidine is effective and safe for the postoperative analgesia after laparoscopic radical surgery of colon cancer.