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Observation on postoperative analgesia and rapid recovery of patientswith Valve replacement by dexmedetomidine combined with sufentanil

摘要:

【】目的 探讨右美托咪定联合舒芬太尼用于瓣膜置换术患者术后镇痛及快速康复的效果观察。方法 前瞻性收集2017 年1月至2018年5月在我院择期行瓣膜置换术患者60例。根据镇痛泵配药方式不同随机分为2组, 舒芬太尼组(S组,ｎ＝30) 、右美托咪定+舒芬太尼组(D组,n=30)。Ｓ 组： 舒芬太尼液2ug/kg＋ 盐酸托烷司琼注射液5ｍｇ 加生理盐水稀释至100ｍｌ；Ｄ 组： 右美托咪定液2μg /kg＋ 舒芬太尼2ug/kg＋ 盐酸托烷司琼注射液５ｍl加生理盐水稀释至100ｍｌ。镇痛泵泵速2ｍｌ／ｈ , ＰＣＡ 2ｍｌ , 锁定时间1５ｍｉｎ 。记录2组患者拔管后4h、8h、12h、24h 、36h VAS及Ramsay镇静评分,PCA按压次数、首次下床活动时间及住院天数,并观察并发症(恶心、呕吐、头晕、嗜睡)的发生率。结果 右美托咪定+舒芬太尼组术后镇痛在拔管后8h-36h时间点VAS评分明显低于舒芬太尼组P<0.05)；Ramsay评分在拔管后8h-36h时间点D组高于S组(P<0.05)；不良反应发生率D组明显减少,差异具有统计学意义(P<0.05)；D组首次下床活动时间明显早于S组,总住院天数少于S组(P<0.05)。 结论 右美托咪定复合舒芬太尼术后镇痛对瓣膜置换术患者有更好的疗效,不良反应发生率低,可缩短住院时间,加速患者康复。

Abstract:

Objective To investigate the effect of dexmedetomidine combined with sufentanil on postoperative analgesia and rapid recovery in patients with Valve replacement.Methods Forward-looking the 60 patients who underwent Valve replacement in our hospital from January 2017 to May 2018. Patients were randomly devided into two groups by different ways of dispensing in analgesic pump: The sufentanil group(group S, N = 30), and the dexmedetomidine combined with sufentanil group(group D, N = 30). Group S: sufentanil 2ug/kg + toxanisqiong 5mg into 100m L; Group D: dexmedetomidine 2μg/kg + sufentanil 2ug/kg + toxanisqiong 5mg into 100ml. Analgesic pump speed 2m l/h, PCA2ml, lock time 15min. Recorded the scores of VAS and Ramsay 4h, 8h, 12h, 24h, 36h after extraction, the number of times PCA was pressed, the first time of getting out of bed and the number of days in hospital, and the incidence of complications(nausea, vomiting, dizziness, drowsiness). Results The score of VAS and Ramsay in group D was significantly lower