右美托咪定復合舒芬太尼在不同手术术后镇痛中的应用.doc

右美托咪定复合舒芬太尼在不同手术术后镇痛中的应用 姜柳英 郑辉利 厦门大学附属中山医院麻醉科，361004 【摘要】 目的：探讨右美托咪定复合舒芬太尼在不同手术术后镇痛应用效果和临床意义。 方法：90例ASA分级Ⅰ～Ⅱ级、年龄30～65岁以下的择期手术患者使用右美托咪定复合舒芬太尼进行术后镇痛，其中包括30例胃癌根治术（A组），30例宫颈癌根治术（B组），30例全髋关节置换术（C组）；三组均用右美托咪定μg/kg+舒芬太尼μg/kg+托烷司琼mg加入生理盐水稀释至100静脉镇痛泵背景输注速度2m/h，自控给药剂量0.5m,锁定时间15 min。记录术后12、24和48h视觉模拟疼痛(VAS)Ramsay镇静评分患者不良反应发生情况均＜分，P＜0.05VAS评分分VAS评分＜分P＜0.05组患者术后各时点Ramsay镇静评分术后恶心呕吐寒右美托咪定术后镇痛具有良好的。 sulfentanyl in postoperative analgesia of different operation. JIANG Liu-ying, ZHENG Hui-li (Department of anesthesiology, affiliated ZhongShan hospital of Xiamen University, Xia Men, Fujian.) [Abstract] Objective To observe application of dexmedetomidine combined with sulfentanyl in postoperative analgesia of different operation. Methods 90cases patients (ASA I-II, Age 30-65) include gastric cancer radical correction (group A), uterine cervix cancer radical correction (group B) and replacement of total hip (group C) with 30 cases each. Three groups were all administrated of 2μg/kg of dexmedetomidine, 0.15μg/kg of sulfentanyl and 6mg of tropisetron in the postoperative analgesia pumps which were adjusted in a standard of 100 ml volume, first dose of 4ml, bolus dose of 2ml,add dose of 0.5ml and the lock time was 15 min. The visual analogue score(VAS)，Ramsay calm score(6，12，24，and 48h after operation) and adverse reaction were recorded. RESULTS The VAS were lower than four at each time points both in group A and group B. The VAS of group C at each time points were higher than group A and B（P＜0.05amsay calm score were well and the adverse reaction were low among every time points of all three groups. The sleep and conscious-sedation quality of group C were lower than group A and B（P＜0.05 CONCLUSION Dexmedetomidine combined with sulfentanyl in postoperative analgesia were deserve recommended which could offer well analgesia and conscious-sedation with few adverse effect, especially in the belly operation. [Keywords] dexmedetomidine