舒芬太尼复合右美托咪定、阿托品、氟哌利多在胃癌根治术后镇痛效果观察

目的：观察舒芬太尼复合右美托咪定、阿托品、氟哌利多在胃癌根治术后的镇痛效果。方法选择48例行胃癌根治术患者作为研究对象，将其随机分为术后镇痛4组：舒芬太尼组（S组），3种不同剂量的右美托咪定复合舒太尼组（A、B、C组），共4组，每组12例，均加入相同剂量的阿托品、氟哌利多。观察记录4组患者手术后2h（T0）、6h（T1）、12h（T2）、24h（T3）、48h（T4）镇痛、镇静评分和术后不良反应发生率。结果A、B、C三组手术后T0－T3的镇痛、镇静效果均显著好于S组患者（ P＜0．05），T4时相比无显著差异（ P＞0．05）。 B 组术后 T0－T3镇痛镇静效果显著好于A组和C组（P＜0．05）；T4时A组和B组患者镇痛镇静效果比较无显著差异（P＞0．05），C组患者显示存在镇静过度。 A、B、C组患者不良反应发生率显著低于S组（P＜0．05），A、B、C组患者两两比较差异无统计意义（P＞0．05）。结论舒芬太尼复合右美托咪定、阿托品、氟哌利多对胃癌根治术患者的镇痛效果优越，不良反应发生率低，可以作为一种新型镇痛药物和平衡镇痛模式，且右美托咪定剂量0．075μg／（ kg?h）为最佳剂量。

The Postoperative Analgesia Efficacy of Sufentanil Combined with Dexmedetomidine,Atropine and Droperidol in Analgesia after Gastric Cancer Radical Resection

ABSTRACT:OBJECTIVE To observe sufentanil combined with dexmedetomidine ,atropine and droperidol in an-algesia after radical resection of gastric cancer .METHODS 48 patients with gastric cancer radical surgery patients as the object of study and randomly divided into 4 groups as postoperative analgesia:sufentanil group ( S group) and three different doses of dexmedetomidine fixed composite Shu fentanyl group (A,B,C group).4 groups (n=12) re-ceived the same dose of supporting products and droperidol .2h (T0),6h (T1),12h,(T2),24h(T3),48h (T4), and the incidence of adverse reactions were observed .RESULTS The analgesic and sedative effects of T0-T3,B,C three groups were significantly better than those in S group ( P<0.05 ) , and T4 there was no significant difference between A and B ( P<0.05 ) .The sedation effect of T 0-T3 in B group was significantly higher than that in A group and C group (P<0.05).There was no significant difference between A group and B group (P>0.05),and the pa-tients in group C showed the presence of sedation .The incidence of adverse reactions in group A ,B and C were sig-nificantly lower than that in S group ( P<0.05 ) ,and the difference was statistically significant ( P>0.05 ) in pa-tients in A,B and C group.CONCLUSION Sufentanil compound dexmedetomidine ,atropine,droperidol analgesic effect in patients with gastric cancer radical is superior ,the low incidence of adverse reactions ,can be used as a new type of analgesic drugs and balance analgesia mode ,and the right supporting the mi organism dose 0.075μg? kg -1 .H as the best dosage.