摘要
【目的】探讨不同剂量右美托咪定(Dex)对老年腹腔镜胃癌根治术(LAP)患者的镇痛效果的影响。【方法】老年胃癌行LAP患者120例,均采用Dex镇痛,随机分成小剂量组(A组)和大剂量组(B组)。两组均于麻醉诱导前取0.5 μg/kg Dex注射,术中给予不同剂量Dex镇痛,其中A组取0.5 μg/(kg·h)泵注,B组取1.0 μg/(kg·h)泵注。分别在术前(T0)、术后即刻(T1)、术后6 h(T2)、术后12 h(T3)、术后24 h(T4)、术后48 h(T5)、术后72 h(T6)利用视觉模拟评分法(VAS)评价两组疼痛程度。分别在术前、术后72 h检测两组血清皮质醇(Cor)、肾上腺素(E)、去甲肾上腺素(NA)水平,并记录两组不良反应情况。【结果】两组T1、T2、T3、T4、T5、T6的VAS评分均低于T0(P<0.05),且两组T5、T6的VAS评分低于T1、T2、T3、T4(P<0.05),B组T1、T2、T3、T4、T5、T6的VAS评分低于A组(P<0.05)。两组术后72 h的血清Cor、E、NA高于术前,且B组低于A组(P<0.05)。两组不良反应发生率相比较差异无显著性(P>0.05)。【结论】与0.5 μg/(kg·h)Dex相比,1.0 μg/(kg·h)Dex给药不仅能取得较好的镇痛效果,而且可减轻术后应激反应,未增加不良反应风险。
【Objective】To investigate the effect of different doses of dexmedetomidine(Dex) on analgesia in elderly patients undergoing laparoscopic radical gastrectomy(LAP).【Methods】 A total of 120 elderly gastric cancer patients with LAP who received Dex for analgesia were random divided into low-dose group (group A) and high-dose group (group B),with 60 cases in each group.Both groups were injected with 0.5 μg/kg Dex before induction of anesthesia.Different doses of Dex were given intraoperatively for analgesia.Patients in group A received 0.5 μg/(kg·h) pump,and patients in group B received 1.0μg/(kg·h) Dex pump.VAS was used to evaluate the pain degree before operation (T0),immediately after operation (T1),6 h after operation (T2),12 h after operation (T3),24 h after operation (T4),48 h after operation (T5) and 72 h after operation (T6).Serum cortisol (Cor),adrenaline (E) and norepinephrine (NA) levels were measured before and 72 h after operation,and adverse reactions were recorded.【Results】The VAS scores of T1,T2,T3,T4,T5 and T6 in the two groups were lower than those of T0 (P<0.05),and the VAS scores of T5 and T6 in the two groups were lower than those of T1,T2,T3 and T4(P<0.05).The VAS scores of T1,T2,T3,T4,T5 and T6 in group B were lower than those in group A,and there were significant differences between the two groups (P<0.05).Serum levels of Cor,E and NA at 72 h after operation in the two groups were higher those before operation(P<0.05),and those in group B were lower than group A (P<0.05).There was no significant difference in the incidence of adverse reactions between the two group (P>0.05).【Conclusion】Compared to 0.5 μg/(kg·h) Dex,high dose of Dex [1.0μg/(kg·h)]not only achieves better analgesic effect,but also reduces post-operative stress response without increasing the risk of adverse reactions.
作者
黄雪梅
魏福生
冯海霞
HUANG Xue-mei;WEI Fu-sheng;FENG Hai-xia(Department of Anesthesiology,Mianyang Central Hospital,Mianyang,Sichuan,621000)
出处
《医学临床研究》
CAS
2019年第8期1504-1506,共3页
Journal of Clinical Research
