右美托咪定复合舒芬太尼对妇科腹腔镜手术患者术后疼痛及安全性影响
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摘要
目的探讨右美托咪定复合舒芬太尼对妇科腹腔镜手术患者术后疼痛及安全性的影响。方法选取2016年4月～2017年4月我院收治的行妇科腹腔镜手术患者共80例,按随机数字表法分为对照组(40例)和观察组(40例),对照组给予舒芬太尼(1.5μg/kg),观察组在此基础上给予右美托咪定(1.0μg/kg)进行麻醉,比较两组患者术后2、6、12、24、48h的疼痛视觉模拟(VAS)评分、Ramsay镇静评分及不良反应发生率。结果观察组术后2、6、12及24h的VAS评分均显著低于对照组,差异有统计学意义(P <0.05),而术后48h两组患者的VAS评分差异均无统计学意义(P> 0.05);观察组术后2、6、12h的Ramsay镇静评分显著低于对照组,差异有统计学意义(P <0.05),而术后24、48h两组患者的的Ramsay镇静评分差异均无统计学意义(P> 0.05);两组患者呼吸抑制、头晕头痛、恶心呕吐及心动过缓的发生率差异均无统计学意义(P> 0.05);观察组患者术后不良反应发生率(10.00%)显著低于对照组(32.50%),差异有统计学意义(P <0.05)。结论右美托咪定复合舒芬太尼用于妇科腹腔镜术后镇痛的效果更优,不良反应少,安全性高,值得临床推广。
Objective To explore the effect dexmedetomidine combined with sufentanil on postoperative pain and safety in patients undergoing gynecologic laparoscopic surgery. Methods 80 patients undergoing gynecologic laparoscopic surgery who were admitted and treated in our hospital from April 2016 to April 2017 were selected and they were randomly divided into control group(40 cases) and observation group(40 cases) according to the random number table method.The control group was given sufentanil(1.5μg/kg) while the control group was given dexmedetomidine(1.0μg/kg) for anesthesia.The Visual analogue pain(VAS) score,Ramsay sedation score and incidence of adverse reaction were compared between the two groups at 2,6,12,24,and 48 hours after surgery. Results The VAS scores of the observation group at 2,6,12 and 24 hours after surgery were significantly lower than those of the control group(P < 0.05),and the difference was statistically significant(P < 0.05).However,there was no statistically significant difference in VAS score between the two groups at 48 hours after surgery(P > 0.05).The Ramsay sedation scores of the observation group at 2,6 and 12 hours after surgery were significantly lower than those of the control group(P< 0.05),and the difference was statistically significant(P < 0.05).However,there was no statistically significant difference in the Ramsay sedation score between the two groups at 24 and 48 hours after surgery(P > 0.05).There was no statistically significant difference in the incidence of respiratory depression,dizziness,headache,nausea and vomiting and bradycardia between two groups(P > 0.05).The incidence of postoperative adverse reactions in the observation group(10.00%) was significantly lower than that in the control group(32.50%),and the difference was statistically significant(P < 0.05).Conclusion Dexmedetomidine combined with sufentanil is more effective in analgesia after gynecologic laparoscopic surgery.It has fewer adverse reactions and high safety,which is worthy of clinical promotion.
Objective To explore the effect dexmedetomidine combined with sufentanil on postoperative pain and safety in patients undergoing gynecologic laparoscopic surgery. Methods 80 patients undergoing gynecologic laparoscopic surgery who were admitted and treated in our hospital from April 2016 to April 2017 were selected and they were randomly divided into control group(40 cases) and observation group(40 cases) according to the random number table method.The control group was given sufentanil(1.5μg/kg) while the control group was given dexmedetomidine(1.0μg/kg) for anesthesia.The Visual analogue pain(VAS) score,Ramsay sedation score and incidence of adverse reaction were compared between the two groups at 2,6,12,24,and 48 hours after surgery. Results The VAS scores of the observation group at 2,6,12 and 24 hours after surgery were significantly lower than those of the control group(P < 0.05),and the difference was statistically significant(P < 0.05).However,there was no statistically significant difference in VAS score between the two groups at 48 hours after surgery(P > 0.05).The Ramsay sedation scores of the observation group at 2,6 and 12 hours after surgery were significantly lower than those of the control group(P< 0.05),and the difference was statistically significant(P < 0.05).However,there was no statistically significant difference in the Ramsay sedation score between the two groups at 24 and 48 hours after surgery(P > 0.05).There was no statistically significant difference in the incidence of respiratory depression,dizziness,headache,nausea and vomiting and bradycardia between two groups(P > 0.05).The incidence of postoperative adverse reactions in the observation group(10.00%) was significantly lower than that in the control group(32.50%),and the difference was statistically significant(P < 0.05).Conclusion Dexmedetomidine combined with sufentanil is more effective in analgesia after gynecologic laparoscopic surgery.It has fewer adverse reactions and high safety,which is worthy of clinical promotion.
引文
[1]麦伟良,张敏森,陈荣强,等.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[J].中国当代医药,2018,25(20):121-124.
[2]熊中华.右美托咪定联合舒芬太尼在妇科腹腔镜术后的镇痛效果[J].中国乡村医药,2018,25(12):32-33.
[3]张阿曼,裴晓娟,张鸿,等.右美托咪定对行腹腔镜术妇科疾病患者术后VAS评分影响及安全性研究[J].陕西医学杂志,2018,47(1):87-89.
[4]徐德芬.右美托咪定对妇科患者腹腔镜术后镇痛效果的研究[J].川北医学院学报,2017,32(6):907-910.
[5]孙宏广,龙志鑫,魏喜静,等,李广伟.右美托咪定对妇科腹腔镜手术患者的影响[J].实用药物与临床,2017,20(12):1400-1402.
[6]黎海平,石少梅,李宇,等.舒芬太尼在妇科腹腔镜手术麻醉中的应用进展[J].医学综述,2017,23(7):1388-1392.
[7]张杰.右美托咪定用于妇科腹腔镜手术患者全麻苏醒期的有效性和安全性[J].中国临床新医学,2017,10(1):50-53.
[8]吴秀秀,陈永权,薛玉荣,等.右美托咪定不同给药方式对妇科腹腔镜患者血流动力学及术后镇痛的影响[J].中国临床药理学与治疗学,2016,21(7):821-825.
[9]谢爱荣,夏连香.右美托咪定联合舒芬太尼在妇科手术中的镇静、镇痛效果观察[J].中国当代医药,2016,23(18):66-68.
[10]李瑞,周晓琴,陈水成.浅析舒芬太尼联合右美托咪定在妇科腹腔镜手术患者术后镇痛中的效果[J].黑龙江医药,2016,29(3):454-456.
[11]黄穗萍,黄晓雷,齐晓非.右美托咪定用于妇科腹腔镜手术的临床分析[J].中国医学创新,2012,9(22):16-18.
[12]张焕焕,李阳,滕秀飞,等.右美托咪定复合舒芬太尼用于妇科腹腔镜手术患者术后镇痛的效果观察[J].中国医科大学学报,2016,45(4):333-336.
[13]贾杰,李屹,胡祖荣,等.右美托咪定在妇科腹腔镜手术术后镇痛效果的评价[J].吉林医学,2013,34(25):5149-5151.
[14]吴娴,徐海军,王立伟,等.右美托咪定在妇科腹腔镜手术中的应用效果研究[J].热带医学杂志,2015,15(5):655-658.
[15]谢国强,陈秀瑜,何永消,等.右美托咪定联合舒芬太尼在腹腔镜下经腹阴道联合子宫切除术中的应用效果[J].中国当代医药,2018,25(15):71-73.
[16]张昱昊,段光友,张咸伟,等.右美托咪定对妇科手术麻醉诱导期舒芬太尼镇痛和镇静效果的影响[J].临床麻醉学杂志,2015,31(2):117-120.
[2]熊中华.右美托咪定联合舒芬太尼在妇科腹腔镜术后的镇痛效果[J].中国乡村医药,2018,25(12):32-33.
[3]张阿曼,裴晓娟,张鸿,等.右美托咪定对行腹腔镜术妇科疾病患者术后VAS评分影响及安全性研究[J].陕西医学杂志,2018,47(1):87-89.
[4]徐德芬.右美托咪定对妇科患者腹腔镜术后镇痛效果的研究[J].川北医学院学报,2017,32(6):907-910.
[5]孙宏广,龙志鑫,魏喜静,等,李广伟.右美托咪定对妇科腹腔镜手术患者的影响[J].实用药物与临床,2017,20(12):1400-1402.
[6]黎海平,石少梅,李宇,等.舒芬太尼在妇科腹腔镜手术麻醉中的应用进展[J].医学综述,2017,23(7):1388-1392.
[7]张杰.右美托咪定用于妇科腹腔镜手术患者全麻苏醒期的有效性和安全性[J].中国临床新医学,2017,10(1):50-53.
[8]吴秀秀,陈永权,薛玉荣,等.右美托咪定不同给药方式对妇科腹腔镜患者血流动力学及术后镇痛的影响[J].中国临床药理学与治疗学,2016,21(7):821-825.
[9]谢爱荣,夏连香.右美托咪定联合舒芬太尼在妇科手术中的镇静、镇痛效果观察[J].中国当代医药,2016,23(18):66-68.
[10]李瑞,周晓琴,陈水成.浅析舒芬太尼联合右美托咪定在妇科腹腔镜手术患者术后镇痛中的效果[J].黑龙江医药,2016,29(3):454-456.
[11]黄穗萍,黄晓雷,齐晓非.右美托咪定用于妇科腹腔镜手术的临床分析[J].中国医学创新,2012,9(22):16-18.
[12]张焕焕,李阳,滕秀飞,等.右美托咪定复合舒芬太尼用于妇科腹腔镜手术患者术后镇痛的效果观察[J].中国医科大学学报,2016,45(4):333-336.
[13]贾杰,李屹,胡祖荣,等.右美托咪定在妇科腹腔镜手术术后镇痛效果的评价[J].吉林医学,2013,34(25):5149-5151.
[14]吴娴,徐海军,王立伟,等.右美托咪定在妇科腹腔镜手术中的应用效果研究[J].热带医学杂志,2015,15(5):655-658.
[15]谢国强,陈秀瑜,何永消,等.右美托咪定联合舒芬太尼在腹腔镜下经腹阴道联合子宫切除术中的应用效果[J].中国当代医药,2018,25(15):71-73.
[16]张昱昊,段光友,张咸伟,等.右美托咪定对妇科手术麻醉诱导期舒芬太尼镇痛和镇静效果的影响[J].临床麻醉学杂志,2015,31(2):117-120.