右美托咪定复合舒芬太尼和单纯舒芬太尼在妇科腹腔镜手术患者术后镇痛中的效果对比(1)
[摘要]目的 比较右美托咪定复合舒芬太尼和单纯舒芬太尼在妇科腹腔镜手术患者术后镇痛中的临床效果。方法 选取2016年6月～2017年6月我院妇产科收治的90例全麻下行妇科腹腔镜手术患者作为研究对象，采用随机数字表法将其分为观察组和对照组，每组各45例。观察组患者予以舒芬太尼(1.5 μg/kg)联合右美托咪定(1.0 μg/kg)，對照组予以单纯舒芬太尼(1.5 μg/kg)。比较观察两组患者术后2～48 h内的视觉模拟评分法(VAS)评分、疼痛程度(BCS)评分、镇静程度(Ramsay)评分、舒芬太尼消耗总剂量及不良反应发生率。结果 术后2、6、12、24 h，观察组患者的VAS评分均低于对照组，差异有统计学意义(P<0.05)，术后48 h，两组患者的VAS评分比较，差异无统计学意义(P>0.05)。术后2、6、12 h，观察组患者的Ramsay评分均低于对照组，BCS评分均高于对照组，差异有统计学意义(P<0.05)，而术后24、48 h，两组患者的Ramsay、BCS评分比较，差异无统计学意义(P>0.05)。术后6、12、24、48 h，两组患者的VAS、BCS、Ramsay评分与本组术后2 h比较，差异均有统计学意义(P<0.05)。观察组患者术后各时间段的舒芬太尼消耗剂量均少于对照组，不良反应总发生率低于对照组，差异有统计学意义(P<0.05)。结论 右美托咪定复合舒芬太尼较单纯舒芬太尼在妇科腹腔镜术后镇痛中的效果更优，能减少舒芬太尼的镇痛消耗剂量，安全性高，临床上值得推广应用。
[关键词]麻醉；术后镇痛；舒芬太尼；右美托咪定；腹腔镜手术
[中图分类号] R614 [文献标识码] A [文章编号] 1674-4721(2018)7(b)-0121-04
[Abstract] Objective To compare the clinical effect of Dexmetodetonidine with Sufentanil and Sufentanil alone in postoperative analgesia after gynecologic laparoscopy. Methods From June 2016 to June 2017， a toatl of 90 patients undergoing general anesthesia for gynaecological laparoscopic surgery in our hospital were selected as subjects. They were randomly divided into observation group and control group according to the random number table method， with 45 cases in each group. The observation group was treated with Sufentanil (1.5 μg/kg) combined with Dexmetodetonidine (1.0 μg/kg)， and the control group was given Sufentanil (1.5 μg/kg) alone. The visual analogue scale (VAS) score， comfort scale (BCS) score， calm degree (Ramsay) score， total dose of Sufentanil consumption， and incidence of adverse reactions were compared between two groups. Results The VAS scores at 2， 6， 12 and 24 h after operation of the observation group were lower than those in the control group， and the differences were statistically significant (P<0.05)， there were no statistically significant differences in VAS scores between two groups at 48 h after operation (P>0.05). Ramsay scores at 2， 6 and 12 h after operation of the observation group were lower than those in the control group， BCS scores at 2， 6 and 12 h after operation of the observation group were higher than those in the control group， and the differences were statistically significant (P<0.05). There were no statistically significant differences in BCS scores and Ramsay scores between two groups in 24 and 48 h after operation (P>0.05). There were statistically significant differences in VAS scores， BCS scores， and Ramsay scores at 6， 12， 24 and 48 h after operation of two groups compared with 2 h after operation (P<0.05). The Sufentanil consumption dose was less than that in the control group at different time points after operation，and rate of adverse reaction in the observation group was lower than that in the control group， the differences were statistically significant (P<0.05). Conclusion Dexmedetomidine combined with Sufentanil is more effective than Sufentanil alone in postoperative analgesia after gynecologic laparoscopy and has a high degree of safety， which can reduce the dosage of Sufentanil for analgesia and is worthy of clinical application., http://www.100md.com(麦伟良 张敏森 陈荣强 黄晓华)
[关键词]麻醉；术后镇痛；舒芬太尼；右美托咪定；腹腔镜手术
[中图分类号] R614 [文献标识码] A [文章编号] 1674-4721(2018)7(b)-0121-04
[Abstract] Objective To compare the clinical effect of Dexmetodetonidine with Sufentanil and Sufentanil alone in postoperative analgesia after gynecologic laparoscopy. Methods From June 2016 to June 2017， a toatl of 90 patients undergoing general anesthesia for gynaecological laparoscopic surgery in our hospital were selected as subjects. They were randomly divided into observation group and control group according to the random number table method， with 45 cases in each group. The observation group was treated with Sufentanil (1.5 μg/kg) combined with Dexmetodetonidine (1.0 μg/kg)， and the control group was given Sufentanil (1.5 μg/kg) alone. The visual analogue scale (VAS) score， comfort scale (BCS) score， calm degree (Ramsay) score， total dose of Sufentanil consumption， and incidence of adverse reactions were compared between two groups. Results The VAS scores at 2， 6， 12 and 24 h after operation of the observation group were lower than those in the control group， and the differences were statistically significant (P<0.05)， there were no statistically significant differences in VAS scores between two groups at 48 h after operation (P>0.05). Ramsay scores at 2， 6 and 12 h after operation of the observation group were lower than those in the control group， BCS scores at 2， 6 and 12 h after operation of the observation group were higher than those in the control group， and the differences were statistically significant (P<0.05). There were no statistically significant differences in BCS scores and Ramsay scores between two groups in 24 and 48 h after operation (P>0.05). There were statistically significant differences in VAS scores， BCS scores， and Ramsay scores at 6， 12， 24 and 48 h after operation of two groups compared with 2 h after operation (P<0.05). The Sufentanil consumption dose was less than that in the control group at different time points after operation，and rate of adverse reaction in the observation group was lower than that in the control group， the differences were statistically significant (P<0.05). Conclusion Dexmedetomidine combined with Sufentanil is more effective than Sufentanil alone in postoperative analgesia after gynecologic laparoscopy and has a high degree of safety， which can reduce the dosage of Sufentanil for analgesia and is worthy of clinical application., http://www.100md.com(麦伟良 张敏森 陈荣强 黄晓华)