羟考酮联合右美托咪定用于腹腔镜下结肠癌根治术术后镇痛效果评价

发布时间：2018-08-29 19:31

【摘要】：目的:观察羟考酮联合右美托咪定用于腹腔镜下结肠癌根治术术后镇痛的有效性和安全性。方法:选择腹腔镜下结肠癌根治术术后使用静脉自控镇痛患者60例,采用信封法随机分为对照组和实验组(n=30)。对照组药物为0.5mg·kg-1羟考酮,实验组药物为0.5mg·kg~(-1)羟考酮加2μg·kg~(-1)右美托咪定。2组药物均用生理盐水稀释至100mL并装入镇痛泵,维持量为1mL·h~(-1),单次剂量为1.5mL,锁定时间为10min。记录2组患者在送麻醉后恢复室(T1)及术后6(T2)、12(T3)、24(T4)和48h(T5)时活动痛及静息痛的疼痛视觉模拟(VAS)评分、镇痛泵药物用量、镇痛急救措施次数及术后首次肛门排气时间;观察2组患者术后不良反应、生命体征及Ramsay镇静评分。结果:实验组患者T2~T5时活动痛及T_2~T_4时静息痛VAS评分明显低于对照组(活动痛:PT2~T5=0.000;静息痛:PT2=0.018,PT3=0.001,PT4=0.010);实验组患者镇痛泵药物用量和紧急镇痛措施次数明显少于对照组(P=0.000;P=0.029);实验组患者术后肛门排气时间明显早于对照组(P=0.030);实验组患者恶心发生例数明显少于对照组(P=0.023),2组患者术后48h内其他不良反应发生率比较差异无统计学意义(P0.05)。结论:羟考酮联合右美托咪定可以安全有效地应用于腹腔镜下结肠癌根治术术后镇痛。
[Abstract]:Objective: to observe the efficacy and safety of hydroxycodone combined with dexmetomidine in postoperative analgesia of laparoscopic radical resection of colon cancer. Methods: sixty patients with postoperative patient-controlled intravenous analgesia were randomly divided into control group (n = 30) and experimental group (n = 30). The control group consisted of 0.5mg kg-1 hydroxycodone and the experimental group 0.5mg kg~ (-1) hydroxycodone plus 2 渭 g kg~ (-1) dexmetomidine (2 渭 g kg~ (-1) were diluted into 100mL with normal saline and injected with analgesic pump. The maintenance dose was 1mL h-1, the single dose was 1.5 mL, and the locking time was 10 minutes. The visual analogue (VAS) scores of active and resting pain in recovery room (T1) and postoperative 6 (T2) 12 (T3) and 48 h (T5) were recorded in both groups. The dosage of analgesic pump, the number of analgesic measures and the first anal exhaust time after operation were recorded. Adverse reactions, vital signs and Ramsay sedation score were observed in both groups. Results: the VAS scores of active pain at T2~T5 and resting pain at T_2~T_4 in the experimental group were significantly lower than those in the control group (active pain: PT2T5T5 0.000; resting pain: PT20.018 PT3P 0.001 PT40.010), the dosage of analgesic pump and the number of emergency analgesic measures in the experimental group were significantly lower than those in the control group (P0.000P0.029). The postoperative time of anal exhaust was significantly earlier than that of the control group (P0. 030), and the number of cases of nausea in the experimental group was significantly lower than that in the control group (P0. 023). There was no significant difference in the incidence of other adverse reactions within 48 hours after operation (P0.05). Conclusion: hydroxycodone combined with dexmetidine can be used safely and effectively for postoperative analgesia of colon cancer under laparoscopy.
【作者单位】：浙江大学医学院附属第一医院麻醉科&疼痛科;浙江省杭州市第三人民医院麻醉科;浙江省杭州市第三人民医院外科;
【基金】：浙江省中医药管理局科研项目资助课题(2016ZB067)
【分类号】：R614

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