摘要
目的 研究右美托咪定对Bankart肩袖修复术麻醉苏醒及术后疼痛的影响.方法 将30例择期行Bankart肩袖修复术的患者随机分为右美托咪定组（DEX组）和对照组（C组）,每组15例.DEX组接受右美托咪定负荷量0.5 μg/kg,然后以0.2 μg/（kg · h）持续输注;C组给予等量生理盐水.两组术后均采用舒芬太尼静脉自控镇痛.观察并记录右美托咪定负荷剂量前（T0）和负荷剂量后15 min（T1）、30 min（T2）、45 min（T3）,以及拔管后5 min（T4）的HR和MAP;评估术后1、2、4、8、12、24 h两组患者的VAS评分和镇静评分;记录呼吸恢复时间、睁眼时间、拔管时间、首次要求镇痛时间、24 h舒芬太尼总用量、PCA按压次数,同时观察不良反应的发生情况.结果 与C组比较,DEX组T1~T4各时点HR和MAP显著降低（P〈0.05）;DEX组患者1、2、4、8 h VAS评分显著低于C组,1、2、4 h镇静评分显著高于C组（P〈0.05）;与C组比较,DEX组术后舒芬太尼总用量、PCA 按压次数显著减少,首次要求镇痛时间延长（P〈0.05）;两组自主呼吸恢复时间、睁眼时间和拔管时间比较差异无统计学意义（P〉0.05）.结论 右美托咪定能够增强Bankart肩袖修复术后镇痛镇静效果,减少阿片类药物的用量,对麻醉恢复无明显影响.
Objective To assess the effect of intraoperative infusion of dexmedetomidine on postoperative re- covery and postoperative analgesia in patients undergoing rotator cuff repair surgery. Methods Thirty patients scheduled for rotator cuff repair surgery were randomly assigned to two groups. Group DEX（ n = 15 ）received a loading dose of dexmedetomidine 0.5 μg/kg during induction of anesthesia, followed by a continuous infusion at a rate of 0.2 μg/ （kg-h） throughout the operation. Group C（ n = 15 ）received a volume-matched bolus and infusion of placebo. HR and MAP were recorded before dexmedetomidine loading dose （ T0 ） and at 15,30,45 rain （ T1 - T3 ） after loading dose as well as 5 rain after extubation （T4）. Pain and sedation scores at 1,2,4,8,12 and 24 h after surgery were assessed ; the time to breathing recovery, eye opening, extubation and first analgesia demand were recorded, and the cumulative sufentanil consumption and side-effects were observed. Results The HR and MAP of group DEX were significantly lower than those of group C at T1 - T4 time points （ P 〈 0.05 ）. Compared with group C, the VAS scores of group DEX were significantly lower, and the sedation scores were higher in the early period（ P 〈 0.05 ）. The comsumption of sufentanil of Group DEX was significantly less during the postoperative period, and time to first rescue analgesia was significantly longer than that of group C（ P 〈 0.05）. Both groups were similar with respect to the mean time to trachea extubation and recovery time （ P 〉 0.05 ）. Conclusion Intraoperative continuous dexmedetomidine iv dining rotator cuff repair surgery can provide effective postoperative analgesia, and reduce the postoperative sufentanil requirements without obvious effect on postoperative recovery.
出处
《实用药物与临床》
CAS
2013年第12期1162-1165,共4页
Practical Pharmacy and Clinical Remedies
关键词
右美托咪定
舒芬太尼
术后镇痛
Dexmedetomidine
Sufentanil
Postoperative analgesia
