本文關(guān)鍵詞： 多模式 右美托咪啶 胃癌根治術(shù) 術(shù)后鎮(zhèn)痛　出處：《中國(guó)臨床藥學(xué)雜志》2016年04期 　論文類型：期刊論文

【摘要】：目的評(píng)價(jià)右美托咪啶多模式用藥在開(kāi)腹胃癌根治術(shù)術(shù)后鎮(zhèn)痛的效果。方法采用隨機(jī)數(shù)字表法將本院擇期全身麻醉下開(kāi)腹胃癌根治術(shù)患者60例分為觀察組和對(duì)照組,每組30例。觀察組術(shù)前15 min予右美托咪啶1μg·kg-1,術(shù)中予右美托咪啶0.3μg·kg-1·h-1持續(xù)泵注至手術(shù)結(jié)束前30 min停藥,術(shù)后予舒芬太尼2μg·kg-1、托烷司瓊5 mg、右美托咪啶2μg·kg-1加0.9%氯化鈉溶液至100 m L行靜脈自控鎮(zhèn)痛(PCIA)。對(duì)照組不使用右美托咪啶,術(shù)后予舒芬太尼2μg·kg-1、托烷司瓊5 mg加0.9%氯化鈉溶液至100 m L行PCIA。2組靜脈鎮(zhèn)痛泵背景輸注速度2 m L·h-1,自控給藥劑量0.5 m L,鎖定時(shí)間15 min。采用視覺(jué)模擬疼痛評(píng)分法(VAS)和Ramsay鎮(zhèn)靜評(píng)分(RSS)評(píng)價(jià)術(shù)畢0、4、8、12、24、48 h疼痛程度,記錄惡心嘔吐、寒戰(zhàn)、心動(dòng)過(guò)緩、呼吸抑制等不良反應(yīng)的發(fā)生情況。結(jié)果觀察組在術(shù)后各時(shí)間點(diǎn)VAS評(píng)分明顯低于對(duì)照組(P0.05),在術(shù)后0、4、8 h內(nèi)時(shí)間點(diǎn)RSS明顯高于對(duì)照組(P0.05),在12、24、48 h 2組之間差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。觀察組不良反應(yīng)發(fā)生率明顯低于對(duì)照組(P0.05)。結(jié)論右美托咪啶多模式用藥明顯提高了開(kāi)腹胃癌根治術(shù)術(shù)后鎮(zhèn)痛、鎮(zhèn)靜效果,減少了不良反應(yīng)發(fā)生。
[Abstract]:Objective to evaluate the analgesic effect of dexmetidine after radical gastrectomy for gastric cancer. Methods 60 patients undergoing open radical gastrectomy under general anesthesia in our hospital were randomly divided into two groups: observation group and control group. 30 patients in each group were treated with dexmetidine 1 渭 g 路kg-1 at 15 min before operation and dexmetidine 0.3 渭 g 路kg-1 路h-1 with continuous pump for 30 min before the end of operation. Sufentanil (2 渭 g 路kg -1), tropisetron (5 mg), dexmetidine (2 渭 g 路kg-1) and 0.9% mL sodium chloride solution (100ml) were given for patient-controlled analgesia. After operation, sufentanil 2 渭 g 路kg -1, tropisetron 5 mg plus 0.9% sodium chloride solution to 100ml were given to PCIA.2 group. The background infusion velocity of intravenous analgesia pump was 2 mL 路h-1, the self-controlled dose was 0.5 mL, and the locking time was 15 min. Ramsay sedation score (Ramsay) was used to evaluate the degree of pain 48 hours after operation. Records of nausea, vomiting, shivering, bradycardia, Results the VAS score in the observation group was significantly lower than that in the control group at each time point, and the RSS was significantly higher in the observation group than that in the control group within 8 hours after operation at 0 ~ 4 hours, but there was no significant difference between the two groups at 12: 24 and 48 h. The incidence of adverse reactions in the observation group was significantly lower than that in the control group (P 0.05). Sedation effect reduced the occurrence of adverse reactions.
【作者單位】： 浙江大學(xué)金華醫(yī)院-金華市中心醫(yī)院麻醉科;
【分類號(hào)】：R614
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本文編號(hào)：1525000