舒芬太尼复合右美托咪定用于宫颈癌根治术术后镇痛的效果观察

目的：观察舒芬太尼复合右美托咪啶在宫颈癌根治术术后镇痛的效果。方法：选取ASAⅠ~Ⅱ级的择期宫颈癌根治术患者56例,随机分为观察组和对照组,对照组术后镇痛给予舒芬太尼1.0μg·kg-1·d-1,观察组术后镇痛给予舒芬太尼1.0μg·kg-1·d-1＋右美托咪定1.0μg·kg-1·d-1,2组术后镇痛持续量2 ml/h,单次负荷剂量2 ml,锁定时间15 min,总容量100 ml。采用疼痛视觉模拟（ VAS）评分评价2组手术结束时（ T1）及术后2 h（ T2）、8 h（ T3）、24 h（ T4）与48 h（ T5）疼痛程度和镇静评分标准（ Ramsay）分级；记录导尿管不适、呕吐、恶心发生率和患者满意度。结果：2组术后各时点疼痛VAS评分均〈4分,T2~T5时点观察组疼痛VAS评分显著低于对照组（P〈0.01）；T2~T5时点观察组Ramsay分级均明显低于对照组（P〈0.01）；观察组导尿管不适、恶心、呕吐发生率均低于对照组（P〈0.05）；观察组患者满意度高于对照组（P〈0.05）。结论：舒芬太尼复合右美托咪啶适合在宫颈癌根治术后镇痛中使用,与单纯舒芬太尼相比较,术后镇痛效果更好,不良反应发生率更低,患者更为舒适。

Effect of the sufentanil combined with dexmedetomidine on postoperative analgesia in cervical cancer patients with radical hysterectomy

Objective：To observe the effects of sufentanil combined with dexmedetomidine on postoperative analgesia in cervical cancer patients with radical hysterectomy. Methods：Fifty-six ASAⅠor Ⅱcervical cancer patients scheduled by radical hysterectomy were randomly divided into the observation group and control group（28 cases each group）. At postoperative analgesia,the control group were treated with sufentanil for 1. 0 μg · kg-1 · d-1 , the observation group were treated with sufentanil for 1. 0 μg · kg-1 · d-1 combined with dexmedetomidine for 1.0 μg·kg-1·d-1,the postoperative analgesia continuous perfusion amount for 2 ml/h,single bolus for 2 ml,lockout time for 15 min and total volume for 100 ml were implemented in two groups. The degree of pain and sedation grade in two groups were evaluated using visual analog scale（VAS） after operation（T1） and at 2（T2）,8（T3）,24（T4） and 48 hours （ T5 ） after operation. The incidences of bladder discomfort,nausea and vomiting,and satisfaction of patients in two groups were recorded after operation. Results：The postoperative VAS scores in two groups in all time points were less than 4. The pain scores of the observation group at T2 to T5 were significantly lower than that of the control group（P〈0. 01）. The Ramesay grades of the observation group at T2 to T5 were significantly lower than that of the control group（P〈0. 01）. The incidences of bladder discomfort,nausea and vomiting in observation group were lower than those in control group（P〈0. 05）,the satisfaction of patient in observation group were higher than that in control group （ P 〈 0. 05 ）. Conclusions：The postoperative analgesia effects of sufentanil combined with dexmedetomidine on radical hysterectomy are better than that of sufentanil,which is lower adverse reaction and more comfortable.