右美托咪定复合芬太尼用于痔术后自控镇痛

目的：探讨右美托咪啶复合芬太尼在痔手术后行自控镇痛的效果。方法：100例痔术后患者随机双盲分为F组（芬太尼8μg/mL,PCA）和FD组（芬太尼8μg/mL复合右美托咪啶4μg/mL，PCA）行自控镇痛。观察24 h内PCA自控追加要求，疼痛强度，患者情绪变化以及PCA相关的不良事件的记录。结果：FD组在术后0～48 h内显著降低芬太尼需要量，从术后第4 h开始显著降低疼痛级别；FD组焦虑情绪和血浆皮质醇浓度较F组显著降低。结论：右美托咪定复合芬太尼行静脉自控镇痛可显著节约芬太尼用量，减少恶心发生率，无过度镇静和不良的血流动力学变化。

Dexmedetomidine Combined with Fentanil on Haemorrhoidectomy Postoper-ative Patient Controlled In-travenous Analgesia

Objective To examine whether combining dexmedetomidine and fentanyl for patient-controlled analgesia （PCA） could improve analgesia while reducing fentanyl-related side-effects. Methods One hundred patients undergoing haemorrhoidectomy were allocated to receive either fentanyl alone 8μg/mL （Group F） or fen-tanyl 8 μg/mL plus dexmedetomidine 4 μg/mL （Group FD） for postoperative i.v. PCA, which was programmed to deliver 0.5 mL per demand with a 15 min lockout interval. Cumulative PCA requirements, pain intensities and PCA-related adverse events were recorded for 24 h after operation. Results Compared with Group F, patients in Group FD required considerably less fentanyl during the 0~48 h postoperative period and reported significant-ly lower pain levels from the fourth postoperative hour onwards. At each observational time point, decreases in level of anxiety and plasma cortisol concentration were significantly greater in Group FD than in Group F. Their was no apparent bradycardia, hypotension, oversedation, or respiratory depression in Group FD. Conclusion The addition of dexmedetomidine to i.v. fentanyl resulted in superior analgesia, significant fentanyl sparing, less fentanyl-induced nausea, and was devoid of additional sedation and untoward haemodynamic changes.