摘要
目的探讨静-吸复合气管内插管全身麻醉联合不同镇痛药物对胃癌术后镇痛时效的影响。方法将择期行胃癌根治性手术的患者随机分为对照组、观察组,各30例。两组患者均采用静-吸复合气管内插管全身麻醉,行常规胃癌根治术后,行静脉镇痛泵(PCIA)治疗。对照组的镇痛液由枸橼酸舒芬太尼注射液3μg/h、盐酸托烷司琼注射液5 mg组成,研究组的镇痛液由枸橼酸舒芬太尼注射液2μg/h、盐酸托烷司琼注射液5 mg及盐酸右美托咪定注射液0. 05μg/kg·h组成。比较两组术后4、8、16、24、48 h的平均动脉压(MAP)、心率(HR)变化、镇痛评分、术后48 h内睡眠质量及不良反应。结果研究组术后4、8、16、24、48 h的MAP、HR值明显低(慢)于对照组(P <0. 05)。研究组术后4、8 h的镇痛评分明显低于对照组(P <0. 05),术后16、24、48 h与对照组比较无统计学意义(P> 0. 05)。研究组术后48 h内睡眠质量明显优于对照组(P <0. 05)。两组不良反应比较无统计学意义(P> 0. 05)。结论胃癌术后患者采用右美托咪定联合舒芬太尼行PCIA可明显延长镇痛时效,维持心血管系统稳定,改善睡眠质量,安全性和舒适度均较好。
Objective To investigate the effect of postoperative analgesia aging of gastric cancer treated by combination of static-absorption endotracheal intubation,general anesthesia and different analgesic drugs. Methods 60 patients scheduled for radical surgery of gastric cancer were randomly divided into the control group,and the observation group,each with 30 cases.Both groups received general anesthesia with intravenous inhalation and endotracheal intubation,and were treated with PCIA after radical resection of gastric cancer.The analgesic solution in the control group consisted of Sufentanil Citrate Injection 3 g/h and Tropisetron Hydrochloride Injection 5 mg,and the analgesic fluid in the study group consisted of Sufentanil Citrate Injection 2 g/h,Tropisetron Hydrochloride Injection 5 mg and Dexmedetomidine Hydrochloride Injection 0.05 μg/kg·h.The mean arterial pressure（MAP）,heart rate（HR） and analgesic scores at 4,8,16,24 and 48 h after operation,the quality of sleep within 48h after operation and adverse reactions between the 2 groups were compared. Results The MAP and HR values at 4,8,16,24 and 48 h after operation in the study group were significantly lower（slower） than those of the control group（ P〈0.05）.The analgesic scores at 4,8 h after operation of the study group were significantly lower than those in the control group（ P〈0.05）,and there were no significant difference at 16,24 and 48 h after operation（ P〉0.05）.The sleep quality in the study group within 48 h after operation was significantly better than that of the control group（ P〈0.05）.There were no significant difference in adverse reactions between the 2 groups（ P〉0.05）. Conclusion Dexmedetomidine combined with sufentanil for PCIA can significantly prolong the analgesic effect in patients with gastric cancer after operation,and maintain the stability of the cardiovascular system,and improve sleep quality,which have a better safety and comfort.
作者
党璐
毕翻利
高洁
常宝生
DANG Lu;BI Fanli;GAO Jie;et al.(Yan＇an University Affiliated Hospital,Yan＇an,716000)
出处
《实用癌症杂志》
2018年第10期1620-1623,共4页
The Practical Journal of Cancer
关键词
右美托咪定
舒芬太尼
胃癌
术后镇痛
Dexmedetomidine
Sufentanil
Gastric cancer
Postoperative analgesia
