右美托咪定对氟比洛芬酯多模式镇痛效果的影响-中国肿瘤临床.PDF

274 中国肿瘤临床2017年第44卷第6期 ChinJClinOncol2017.Vol.44.No.6 临床研究与应用 · · 右美托咪定对氟比洛芬酯多模式镇痛效果的影响 韩雪 刘玲 张广华 摘要 目的：观察右美托咪定对氟比洛芬酯多模式镇痛效果的影响。方法：选取2016年1月至2016年5月于天津医科大学肿瘤 医院择期行直肠癌切除术的肿瘤患者共90例，随机分为A、B、C3个组，每组30例。A、B两组术前静注氟比洛芬酯行超前镇痛，C 组（对照组）静注脂肪乳2mL。术后镇痛泵配制方法：A组为氟比洛芬酯+右美托咪定+舒芬太尼；B组为氟比洛芬酯+舒芬太尼；C 组为舒芬太尼+脂肪乳，三组均加生理盐水至100mL。分别记录术后4h（T1）、8h（T2）、12h（T3）、24h（T4）、48h（T5）咳嗽时疼痛 视觉模拟评分（VAS）及Ramsay镇静评分；记录术后24h止疼泵有效按压次数及舒芬太尼用药量、术前及术后30min血糖、术前及 术后48hC反应蛋白（C-reactionprotein，CRP）；观察术后48h加强镇痛例数及不良反应例数。结果：A组T1、T2时Ramsay镇静评 分高于B、C组，T1、T2、T3咳嗽时VAS评分、止疼泵有效按压次数、舒芬太尼消耗量、术后血糖和CRP明显小于B、C两组（P 0.05）。A、B两组间不良反应例数差异无统计学意义且均低于C组（均P0.05）。结论：右美托咪定联合氟比洛芬酯多模式镇痛用 于直肠癌根治术患者，可增强其镇痛镇静效果，减少应激和炎症反应且不增加不良反应的发生风险。 关键词 右美托咪定 氟比洛芬酯 多模式镇痛 超前镇痛 doi:10.3969/j.issn.1000-8179.2017.06.855 Influence of dexmedetomidine on the multimodal analgesic effect of flurbiprofen axetil Xue HAN, Ling LIU, Guanghua ZHANG Correspondence to: Guanghua ZHANG; E-mail: zghttyyyy@ Department of Anesthesia, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer ,Tian- jin Key Laboratory of Cancer Prevention and Therapy , Tianjin s Clinical Research Center for Cancer, Tianjin 300060, China Abstract Objective: To observe the influence of dexmedetomidine on the multimodal analgesic effect of flurbiprofen axetil on pa- tients subjected to radical resection of rectal carcinoma. Methods: Ninety patients who underwent abdominal resection of rectal carci- noma were selected and randomly divided into three groups (30 patients in each group). The patients in groups A and B were intrave- nously injected with flurbiprofen axetil 30 min before operation to achieve preemptive analgesia, while the patients in group C were pretreated with 2 mL lipid emulsion through intravenous injection. Patient-controlled intravenous analgesia pump was prepared as fol- lows: flurbiprofen axetil + dexmedetomidine + sufentanil for