右美托咪啶多模式用药的术后静脉自控镇痛效果评价

发布时间：2018-02-22 18:23

  本文关键词： 多模式 右美托咪啶 胃癌根治术 术后镇痛　出处：《中国临床药学杂志》2016年04期 　论文类型：期刊论文

【摘要】：目的评价右美托咪啶多模式用药在开腹胃癌根治术术后镇痛的效果。方法采用随机数字表法将本院择期全身麻醉下开腹胃癌根治术患者60例分为观察组和对照组,每组30例。观察组术前15 min予右美托咪啶1μg·kg-1,术中予右美托咪啶0.3μg·kg-1·h-1持续泵注至手术结束前30 min停药,术后予舒芬太尼2μg·kg-1、托烷司琼5 mg、右美托咪啶2μg·kg-1加0.9%氯化钠溶液至100 m L行静脉自控镇痛(PCIA)。对照组不使用右美托咪啶,术后予舒芬太尼2μg·kg-1、托烷司琼5 mg加0.9%氯化钠溶液至100 m L行PCIA。2组静脉镇痛泵背景输注速度2 m L·h-1,自控给药剂量0.5 m L,锁定时间15 min。采用视觉模拟疼痛评分法(VAS)和Ramsay镇静评分(RSS)评价术毕0、4、8、12、24、48 h疼痛程度,记录恶心呕吐、寒战、心动过缓、呼吸抑制等不良反应的发生情况。结果观察组在术后各时间点VAS评分明显低于对照组(P0.05),在术后0、4、8 h内时间点RSS明显高于对照组(P0.05),在12、24、48 h 2组之间差异无统计学意义(P0.05)。观察组不良反应发生率明显低于对照组(P0.05)。结论右美托咪啶多模式用药明显提高了开腹胃癌根治术术后镇痛、镇静效果,减少了不良反应发生。
[Abstract]:Objective to evaluate the analgesic effect of dexmetidine after radical gastrectomy for gastric cancer. Methods 60 patients undergoing open radical gastrectomy under general anesthesia in our hospital were randomly divided into two groups: observation group and control group. 30 patients in each group were treated with dexmetidine 1 渭 g 路kg-1 at 15 min before operation and dexmetidine 0.3 渭 g 路kg-1 路h-1 with continuous pump for 30 min before the end of operation. Sufentanil (2 渭 g 路kg -1), tropisetron (5 mg), dexmetidine (2 渭 g 路kg-1) and 0.9% mL sodium chloride solution (100ml) were given for patient-controlled analgesia. After operation, sufentanil 2 渭 g 路kg -1, tropisetron 5 mg plus 0.9% sodium chloride solution to 100ml were given to PCIA.2 group. The background infusion velocity of intravenous analgesia pump was 2 mL 路h-1, the self-controlled dose was 0.5 mL, and the locking time was 15 min. Ramsay sedation score (Ramsay) was used to evaluate the degree of pain 48 hours after operation. Records of nausea, vomiting, shivering, bradycardia, Results the VAS score in the observation group was significantly lower than that in the control group at each time point, and the RSS was significantly higher in the observation group than that in the control group within 8 hours after operation at 0 ~ 4 hours, but there was no significant difference between the two groups at 12: 24 and 48 h. The incidence of adverse reactions in the observation group was significantly lower than that in the control group (P 0.05). Sedation effect reduced the occurrence of adverse reactions.
【作者单位】： 浙江大学金华医院-金华市中心医院麻醉科;
【分类号】：R614
，

本文编号：1525000