胡亚娟舒芬太尼复合右美托咪定妇科腔镜手术术后镇痛效果探讨.doc

WORD格式可编辑 专业知识整理分享 舒芬太尼复合右美托咪定妇科腔镜手术术后镇痛效果探讨 作者 [摘要] 目的 探讨舒芬太尼复合右美托咪定应用于妇科腔镜手术术后镇痛的疗效。方法 选取2011年1月至2012年12月行妇科腔镜手术患者90例，随机分为3组，每组30人，Ⅰ组采用舒芬太尼1.5μg／(kg·d)+格拉司琼6 mg /1O0 ml，Ⅱ组采用舒芬太尼1.0μg／(kg·d)+格拉司琼6 mg／lO0 ml，Ⅲ组术后镇痛采用舒芬太尼1.0μg／(kg·d)+右美托咪定1.0 g／(kg·d)+格拉司琼6 mg／lO0 ml。通过视觉模拟评分法及镇痛泵总按压次数、有效按压次数及术后不良反应对三组患者镇痛效果进行评定。结果 根据三组患者术后VSA评分，Ⅰ、Ⅲ组术后4小时、8小时、12小时、24小时、48小时镇痛效果明显优于对照组(P0．05)，Ⅰ、Ⅲ组VAS评分无明显统计学差异，Ⅱ组镇痛泵按压次数高于Ⅰ、Ⅲ组，有效按压次数低于Ⅰ、Ⅲ组，Ⅲ组按压有效率高于Ⅰ组和Ⅱ组。Ⅰ组胃肠道反应的发生率明显高于Ⅱ组和Ⅲ组(P0．05)，Ⅲ组心动过缓发生率明显高于其他两组（P＞0.05）。 结论 右美托咪定可降低舒芬太尼使用剂量但不影响其药效，并且可降低术后恶心呕吐等胃肠道反应，安全有效，是临床切实可行的方法。 [关键词] 妇科腔镜手术；舒芬太尼；右美托咪定；术后镇痛 Observation of effect on Sufentanil combined with Dexmedetomidine on postoperative analgesia in patients undergoing gynecological laparoscopic surgery [Abstract] Objective To explore the the cIinicaI effect of SufentaniI combined with Dexmedetomidine on postoperative analgesia in patients undergoing gynecological laparoscopic surgery． Methods In this case series, from January 2011 to December 2010 , 90 cases of patients undergoing gynecological laparoscopic surgery, divided into three groups, with 30 cases in each group. Group Ⅰreceived Sufentanil 1.5μg／(kg·d)+ Granisetron6 mg /1O0 ml, group Ⅱreceived Sufentanil 1.0μg／(kg·d)+ Granisetron6 mg /100 ml, group Ⅲ received Sufentanil 1.0μg／(kg·d)+ Granisetron6 mg /100 ml+ Dexmedetomidine 1.0 g／(kg·d). Pain intensith was assessed with visuaI anaIog scaIe (VAS), The use of analgesia pump and the incidence of side effects were recorded. Results According to the VAS, group Ⅰand group Ⅲ showed the batter pain relief than group Ⅱ, the pressing times of group Ⅱwas more than the other group, the incidence of nausea and vomiting in group Ⅰwas higher than groups Ⅱand Ⅲ(P 0.05). Conclusions Dexmedetomidine can reduce postoperative consumption of SufentaniI in patients undergoing gynecological laparoscopic surgery, but has no effect on efficacy, and decrease the incidence of nausea and vomiti