右美托咪定联合舒芬太尼对全麻下行乳腺癌手术患者术后疼痛的影响

目的:观察右美托咪定联合舒芬太尼对全麻下行乳腺癌手术患者术后疼痛的影响。方法:选取我院2013年1月至2015年2月择期行乳腺癌手术患者208例(ASAⅠ~Ⅱ级),入院后随机分为对照组(n=98)和观察组(n=110)。观察组给予枸橼酸舒芬太尼2.0μg/(kg·h)+盐酸右美托咪定0.6μg/(kg·h);对照组给予枸橼酸舒芬太尼2.0μg/(kg·h)+0.9%NS 0.6μg/(kg·h)。观察比较两组患者术后(4 h、8 h、12 h、24 h)的心率、血压、呼吸频率、疼痛评分及不良反应发生率。结果:两组患者在术前及术后4 h、8 h、12 h、24 h的平均动脉压、呼吸频率等指标比较无统计学意义(P>0.05)。两组患者疼痛评分呈上升趋势,至手术后16 h达到峰值;在术后24 h内,观察组疼痛程度评分与对照组比较,有统计学意义(P<0.05)。观察组患者恶心呕吐、寒战发生率显著低于对照组(P<0.05);两组患者均未出现呼吸抑制、低血压及心动过缓等不良反应。两组皮肤瘙痒、嗜睡发生率比较无统计学意义(P>0.05)。结论:右美托咪定联合舒芬太尼能够有效改善乳腺癌患者术后疼痛症状,且两者联合使用对术后寒战等不良反应及生命体征影响较小,值得在临床上推广应用。

Effect of dexmedetomidine combined with sufentanil on postoperative pain of patients with breast cancer surgery under general anesthesia

Objective:To observe the effect of dexmedetomidine combined with sufentanil on postoperative pain of patients with breast cancer operation under general anesthesia.Methods:Two hundred and eight breast cancer patients (ASA grade I-II)were se-lected and randomly divided into control group (n =98)and observation group (n =1 10).Patients in the observation group were given sufentanil 2 μg /(kg·h)and dexmedetomidine 0.6 μg /(kg·h).Patients in the control group were given sufentanil 2 μg /(kg·h) and 0.9% Sodium Chloride Injection 0.6 μg /(kg·h).Heart rate,blood pressure and respiratory rate,pain scores and the incidence of adverse reactions were recorded at the time point of 2 h,4 h,12 h,24 h,and 48 h after the operation.Results:Before and 4 h,8 h,12 h and 24 h after surgery,there was no significant difference between two groups in average arterial pressure,respiratory rate and other indicators (P >0.05).Pain score of two groups showed an upward trend,reaching a peak at 16 h after surgery.Within 24 h af-ter surgery,pain scores of two groups had significant difference (P <0.05).The incidence of nausea,vomiting and chills of observa-tion group was significantly lower than that of the control group (P <0.05);neither of the two groups had no respiratory depression, hypotension and tachycardia,corrosion and other adverse reactions.There was no significant difference between the two groups in the incidence of pruritus and sleepiness (P >0.05 ).Conclusion:Dexmedetomidine combined with sufentanil effectively reduced patient pain,postoperative shivering,which might be useful for clinical application.