右美托咪定联合舒芬太尼术后镇痛效果及安全性的观察

目的：观察右美托咪定与舒芬太尼联合用于全身麻醉患者术后镇痛效果及安全性。方法将120例行全身麻醉手术的患者术后根据镇痛药物不同分为研究组和对照组，每组60例。研究组给予盐酸右美托咪定＋枸橼酸舒芬太尼＋高乌甲素＋雷莫司琼进行静脉自控镇痛（PCIA），对照组给予枸橼酸舒芬太尼＋高乌甲素＋雷莫司琼进行 PCIA。观察2组患者 T0（术后30 min）、T1（术后2 h）、T2（术后4 h）、T3（术后12 h）、T4（术后24 h）、T5（术后48 h）的 Ramsay 镇静评分情况；采用疼痛视觉模拟量表（VAS）对患者各时间点的疼痛情况进行评定；住院期间观察2组患者不良反应（恶心、呕吐、呼吸抑制以及寒战等）发生情况。结果研究组在 T0、T1、T2、T3及 T4时VAS 评分均明显低于对照组（均 P ＜0．05）。T5时2组患者 VAS 评分比较差异无统计学意义（P ＞0．05）。2组T0、T1、T2、T3、T4及 T5各时间点 Ramsay 镇静评分比较差异均无统计学意义（均 P ＞0．05）。研究组不良反应发生率为8．33％，对照组不良反应发生率为11．67％，2组比较差异无统计学意义（P ＞0．05）。结论右美托咪定与舒芬太尼联合用于全身麻醉患者，术后镇痛效果良好，且无明显不良反应。

Efficacy and Safety of Dexmedetomidine Combined Sufentanil for Postoperative Analgesia after Surgery under General Anesthesia

Objective To observe the efficacy and safety of dexmedetomidine combined sufen-tanil for postoperative analgesia after surgery under general anesthesia.Methods A total of 120 patents who underwent surgery under general anesthesia were divided into two groups,with 60 patients in each group.The study group was given patient-controlled intravenous analgesia （PCIA）with dexmedetomidine hydrochloride,sufentanil citrate,lappaconitine and ramosetron. The control group was given PCIA with sufentanil citrate,lappaconitine and ramosetron.Ramsay sedation scores and visual analogue scale（VAS）scores were determined 0.5（T0 ）,2（T1 ）,4（T2 ）, 12（T3 ）,24（T4 ）and 48（T5 ）hours after operation.In addition,the incidence of adverse reactions （nausea,vomiting,respiratory depression,chills,etc.）was recorded in both groups.Results Compared with control group,VAS scores significantly decreased in study group at T0 ,T1 ,T2 ,T3 and T4 （P 〈0.05）.However,no significant differences in VAS scores were found between the two groups at T5 （P 〉0.05）.Furthermore,there were no significant differences in Ramsay sedation scores between the two groups at all time points（P 〉0.05）.Moreover,the incidence of adverse reactions in study group （8.33%） was not obviously different from that in control group （11.67%）（P 〉 0.05）.Conclusion The dexmedetomidine combined sufentanil is effective for postoperative analgesia and does not result in obvious adverse reactions after surgery under gener-al anesthesia.