妇科手术患者应用右美托咪定超前镇痛的临床效果观察

目的探讨妇科手术患者应用右美托咪定超前镇痛的临床效果。方法选择拟行择期妇科手术患者60例，ASAⅠ～Ⅱ级，按随机数字表法分为右美组（n=30）和对照组（n=30）。右美组患者在麻醉诱导前10min先经静脉缓慢泵入右美托咪定0．5μg／kg负荷剂量，10min泵完，然后以0．1μg／（kg·h）速率持续泵注；手术结束前30min停止泵入。对照组术前及术中泵入相同容量生理盐水。观察记录两组患者术后2（（T1）、4（T2）、8（T3）和24h（T4）的疼痛视觉模拟评分（VAS）、镇静Ramsay评分以及术后恶心、呕吐、头晕、头痛和心动过缓等不良反应发生情况。结果右美组患者术后2、4、8和24h的VAS评分及恶心、呕吐、头晕、头痛等不良反应的发生率均明显低于对照组（P〈0．01），Ramsay评分与对照组相比差异无统计学意义（P〉0．05）。结论右美托咪定超前镇痛可以增强妇科手术后镇痛效果，并且明显降低恶心、呕吐等不良反应的发生，值得临床推广应用。

Clinical effect of preemptive analgesia with dexmedetomidine on postoperative analgesia in patients with gynecological operation

Objective To investigate the effect of preemptive analgesia with dexmedetomidine on postoperative analgesia in patients with gynecological operation. Methods A total of 60 female patients with ASA I- II undergoing elective gynecological operation were randomly divided into dexmedetomidine and control groups,30 cases in each group. Before induction of anesthesia,0. 5 μg/kg of dexmedetomidine was slowly infused for 10 min in the dexmedetomidine group by using an intravenous pump,and then O. 1 μg/（ kg· h）of the drug was continuously infused until 30 rain before end of the operation. The same volume of saline was infused in the control group. Score of sedation or analgesia and adverse reactions were recorded at 2 hour after operation（ T1 ） ,4 hour after operation（ T2 ） ,8 hour after operation （ T3 ）, and 24 hour after operation （ T4 ）, respectively. Results The VAS in the dexmedetomidine group were significantly lower than that in the control group at T1 ,T2, T3 and Ta （P 〈 0.01 ）. The score of Ramsay had no significant difference between the two groups at T1 ,T2, T3 and T4. The incidence of nausea, vomiting and dizziness, and headache was lower in the dexmedetomidine group than that in the control group（P 〈 0. 01 ）. Conclusion Preemptive analgesia with dexmedetomidine can enhance the postoperative analgesia in patients with gynecological operations, and reduce nausea and vomiting. It is worthy of clinical application.