資源描述:
《右美托咪定聯(lián)合舒芬太尼對(duì)胃腸道腫瘤患者術(shù)后鎮(zhèn)痛時(shí)效的觀察》由會(huì)員上傳分享,免費(fèi)在線閱讀,更多相關(guān)內(nèi)容在工程資料-天天文庫(kù)。
1、右美托咪定聯(lián)合舒芬太尼對(duì)胃腸道腫瘤患者術(shù)后鎮(zhèn)痛時(shí)效的觀察徐州醫(yī)科大學(xué)江蘇省麻醉學(xué)重點(diǎn)實(shí)驗(yàn)室,江蘇省麻醉與鎮(zhèn)痛應(yīng)用技術(shù)重點(diǎn)實(shí)驗(yàn)室,徐州醫(yī)科大學(xué)附屬醫(yī)院摘要:目的觀察右美托咪定聯(lián)合舒芬太尼對(duì)胃腸道腫瘤患者術(shù)后鎮(zhèn)痛時(shí)效的延長(zhǎng)作用。方法選擇胃腸外科手術(shù)患者60例,根據(jù)入院先后順序分為兩組,舒芬太尼組(S組)、右美托咪定聯(lián)合舒芬太尼組(DS組)。2組患者術(shù)后均用PCIA泵(100ml),設(shè)置均為:背景劑量2ml/h(S組,舒芬太尼0.04Mg.kg1.If1;DS組,右美托咪定0.1ug?kg1?h>舒芬
2、太尼0.04ug?kg1?h1);單次劑量為0.5ml,鎖定時(shí)間15min,對(duì)比兩組術(shù)后3h、6h、12h、24h、48h、72h、96h患者的VAS評(píng)分、Ramsay鎮(zhèn)靜評(píng)分、48hPCIA有效按壓次數(shù),同時(shí)觀察患者術(shù)后惡心、嘔吐、皮膚瘙癢、呼吸抑制等不良反應(yīng)及患者滿意度。結(jié)果術(shù)后3h、6h、12h、24h、48h、72h、96h兩組MAP、HR、SP02、RR比較,差異無統(tǒng)計(jì)學(xué)意義(P〉0.05):術(shù)后3h、6h、12h、24h、48hDS組VASr低于S組,咳嗽時(shí)VASm明顯低于S組,P<
3、0.05;術(shù)后72h、96hDS組患者VASr、VASm顯著低于S組(P<0.05);術(shù)后3h、6h、12h、24h、48h、72h、96h的Ramsay鎮(zhèn)靜評(píng)分明顯高于S組(P〈0.05);48h內(nèi)鎮(zhèn)痛泵的按壓次數(shù)DS組較S組減少(P〈0.05)。兩組術(shù)后不良反應(yīng)發(fā)生率對(duì)比差異無統(tǒng)計(jì)學(xué)意義(P〉0.05),DS組患者滿意度明顯高于S組。結(jié)論患者術(shù)后采用右美托咪定聯(lián)合舒芬太尼PCIA鎮(zhèn)痛,安全有效,可延長(zhǎng)術(shù)后鎮(zhèn)痛作用時(shí)間,減少患者按壓次數(shù),患者滿意度高,值得臨床推廣應(yīng)用。關(guān)鍵詞:右美托咪定;舒芬
4、太尼;術(shù)后鎮(zhèn)痛;自控鎮(zhèn)痛;收稿日期:2017-06-21ClinicalObservationofDexmedetomidineCombinedwithSufentanilonPostoperativeAnalgesiainPatientswithGastricCancerXUDanLIUSuSUNQianweiXuzhouMedicalUniversity,JiangsuKeyLaboratoryofAnesthesiaandAnalgesia;Abstract:ObjectiveToobse
5、rvetheeffectofdexmedetomidinecombinedwithsufentanilonpostoperativeanalgesiainpatientswithgastriccancer.MethodsSelecttheASAclassTorTTundergoinggastrointestinalsurgery(colorectalcarcinoma,gastriccancer,60patients),postoperativepatientsvoluntarilyreceiv
6、edintravenousanalgesiatreatment.Accordingtoadmissionorder,theyweredividedinto2groups:sufentanilgroup(groupS),dexmedetomidinecombinedwithsufentanilgroup(groupDS).Thepatientsinthe2groupsweretreatedwithPCIApump(100ml)aftersurgery,ThePCIApumpparameterswe
7、reasfollow:backgrounddosewas2ml/h(group,Sufentanil0.04ug?kg'1?h—1;groupDS,Dexmedetomidine0.1ug?kg'1?h_1+Dufentanil0.04ug?kg1?h*);thesingledosewas0.5ml,locktimewas15min.The48hpresstimes,theVAS,andRamsaysedationscoreaftersurgeryfor3h,6h,12h,24h,48h,72h
8、and96hwererecorded.Theadversereactionsandpatientsatisfactionofthe2groupswerecompared.ResultsTherewasnosignificantdifferencebetweenthethe2groupsinMAP、HR、SP02、RRat3h,6h,12h,24h,48h,72h,96hafteroperation(P>0.05).TheVASrofgroupDSwaslowerthanthatofSgroupa