右美托咪啶混合舒芬太尼用于腹腔镜下胆囊切除术后自控静脉镇痛的效果

目的评价右美托咪啶混合舒芬太尼用于腹腔镜下胆囊切除术后自控静脉阵痛(PCIA)的效果。方法选择全凭静脉气管插管全身麻醉下进行LC手术患者90例,年龄35~55岁,ASA 1~2级,采用随机数字表法,将患者随机分为3组(n=30):1组于患者苏醒拔管后给予安慰剂(生理盐水)治疗;2组于患者苏醒拔管后采用舒芬太尼进行PCIA[背景输注量0.015μg/(mL.h),PCA量0.023μg/kg,锁定时间15 min];3组于患者苏醒拔管后采用舒芬太尼混合右美托咪啶进行PCIA[右美托咪啶背景输注量0.045μg/(kg.h),PCA量0.07μg/kg,锁定时间15 min舒芬太尼用量用法不变]于术后4、8、16、24 h记录PRINCE-HENRY疼痛评分和RAMSAY镇静评分,于24 h进行患者满意度评价,记录不良反应的发生情况。结果于1组比较2,3组镇痛后效果非常明显;于2组比较3组术后4、8、24 h的PRINCE-HENRY评分和舒芬太尼用量降低,患者满意度升高(P<0.05)其余指标间比较差异无统计学意义。结论右美托咪啶混合舒芬太尼用于腹腔镜下胆囊切除术后自控静脉阵痛的效果优于单独应用舒芬太尼。

The patient-controlled intravenous analgesia(PCIA) effect of Dexmedetomidine mixed with Sulfentanyl used in laparoscopic cholecystectomy(LC)

Objective To evaluate the patient-controlled intravenous analgesia(PCIA) effect of Dexmedetomidine mixed with Sulfentanyl used in laparoscopic cholecystectomy(LC).Methods Ninety patients who received LC with tracheal intubation general anesthesia,aged from 35 to 55,ASA1-2,were randomly divided into 3 groups by table of random digit.Group 1: administrated with placebo(sodium chloride) after extubate;Group 2: administrated with Sulfentanyl as PCIA(background fluence 0.015 μg/(mL·h),PCA dose 0.023 μg/kg,Locked time: 15 minutes) after extubate;Group 3: administrated with the mixture of Dexmedetomidine and Sulfentanyl as PCIA(Dexmedetomidine′s background fluence 0.045 μg/(kg·h),PCA dose 0.07 μg/kg,Locked time 15 min,the Sulfentanyl usage was the same with group 2) after extubate.The scores of PRINCE-HENRY and RAMSAY at the time of 4,8,16,24 h after the operation were recorded to evaluate the patients ′degree of satisfaction,and the bad reflection was also be recorded.Results The effect of analgesia was very obvious in group 2 and 3 in contrast to group 1.The scores of PRINCE-HENRY at 4,8,24 h after operation and the total dose of Sulfentanyl of the group 3 were lower than those of the group 2,but the degree of satisfaction was higher(P<0.05).And the difference in other index was not significant.Conclusion Dexmedetomidine mixed with Sulfentanyl has more advantages than Sulfentanyl as PCIA in LC.