右美托咪定对胃大部切除术后吗啡镇痛效果的影响

发布时间：2018-11-21 15:55

【摘要】：目的观察术中应用右美托咪定对胃大部切除术后应用吗啡进行经静脉患者自控镇痛(PCIA)效果的影响。方法选取拟行胃大部切除术的患者30例,美国麻醉医师协会分级Ⅰ或Ⅱ级,随机分入右美托咪定组(DEX组)和0.9%氯化钠溶液组(对照组),每组15例。麻醉诱导后,DEX组于手术划皮前经静脉泵注射右美托咪定0.5μg/kg,10min内输注完毕,术中以DEX 0.2μg·kg~(-1)·h~(-1)维持,至手术结束前30min停止用药;对照组注射等容量的0.9%氯化钠溶液,方法同DEX组。所有患者术后均行吗啡PCIA。分别于术后1、4、8、12、24h记录患者的疼痛视觉模拟评分(VAS评分),并记录术后第1次追加镇痛药的时间、术后24h吗啡总消耗量和术后不良反应的发生情况。结果 DEX组术后1、4、8、12h的疼痛VAS评分均显著低于对照组同时间点(P值均0.05),两组间术后24h的疼痛VAS评分的差异无统计学意义(P0.05)。DEX组术后第1次追加镇痛药物的时间显著迟于对照组(P0.05),术后24h吗啡总消耗量显著少于对照组(P0.05)。两组间术后恶心呕吐发生率的差异无统计学意义(P0.05)。结论术中应用右美托咪定可显著提高术后应用吗啡进行PCIA的镇痛效果,并可减少阿片类药物的用量。
[Abstract]:Objective to observe the effect of dexmetomidine on patient controlled analgesia (PCIA) after subtotal gastrectomy with morphine. Methods Thirty patients with subtotal gastrectomy were randomly divided into dexmetomidine group (DEX group) and 0.9% sodium chloride solution group (control group). After anesthesia induction, the DEX group was infused with dexmetomidine 0.5 渭 g / kg / kg for 10 minutes before operation, and maintained with DEX 0.2 渭 g kg~ (-1) h ~ (-1) until the end of operation. The control group was injected with 0.9% sodium chloride solution of the same volume as the DEX group. All patients received morphine PCIA. after operation Visual analogue score (VAS) of pain was recorded at 1, 4, 8 and 1224 hours after operation, and the time of the first addition of analgesics, the total consumption of morphine at 24 hours after operation and the occurrence of adverse reactions were recorded. Results the VAS scores of pain in the DEX group were significantly lower than those in the control group at the same time point (P < 0. 05). There was no significant difference in pain VAS score between the two groups 24 hours after operation (P0.05). DEX group, the time of the first time of adding analgesic drugs was significantly later than that of the control group (P0.05). The total morphine consumption at 24 hours after operation was significantly lower than that in the control group (P0.05). There was no significant difference in the incidence of nausea and vomiting between the two groups (P0.05). Conclusion the intraoperative use of dexmetidine can significantly improve the analgesic effect of morphine on PCIA and reduce the dosage of opioid drugs.
【作者单位】：上海交通大学附属第六人民医院麻醉科;复旦大学附属肿瘤医院麻醉科;复旦大学附属中山医院麻醉科;
【分类号】：R614

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