摘要
目的探讨酮咯酸氨丁三醇联合右美托咪定超前镇痛对胸腔镜肺癌根治术患者术后寒战及疼痛的影响。方法抽取2019年1月至2020年6月于南阳市中心医院行胸腔镜肺癌根治术的患者183例,剔除拒绝参与研究者3例,按照超前镇痛方案将其分为对照组(90例)和研究组(90例)。对照组予以右美托咪定及等容量生理氯化钠溶液进行超前镇痛,研究组予以酮咯酸氨丁三醇联合右美托咪定行超前镇痛。比较两组术后寒战发生率和疼痛情况、围术期应激激素水平及不良反应。结果研究组术后寒战总发生率(7.78%,7/90)低于对照组(22.22%,20/90),P<0.05。术后6、12、24 h,研究组视觉模拟评分量表评分低于对照组(t=6.97、6.97、2.06,P均<0.05)。T1(术后2 h)和T2(术后24 h)时两组肾素(Rn)、皮质醇(Cor)、促肾上腺皮质激素(ACTH)高于T0(麻醉诱导前)时(P<0.05),T2时对照组Rn、Cor、ACTH高于T1时(P<0.05),但T1和T2时研究组Rn、Cor、ACTH低于对照组(P<0.05)。研究组恶心呕吐发生率低于对照组(χ^(2)=9.42,P<0.05)。结论酮咯酸氨丁三醇联合右美托咪定超前镇痛用于胸腔镜肺癌根治术,能预防术后寒战发生,增强术后镇痛效果,抑制围术期应激反应,减少不良反应。
Objective To investigate the effect of ketorolac tromethamine combined with dexmedetomidine preemptive analgesia on postoperative shivering and pain in patients undergoing thoracoscopic radical resection of lung cancer.Methods A total of 183 patients who underwent thoracoscopic radical resection of lung cancer in Nanyang Central Hospital from January 2019 to June 2020 were selected,3 patients who refused to participate in the researcher were excluded,and they were divided into the control group(90 cases)and the research group(90 cases)according to the preemptive analgesia plan.The control group was given dexmedetomidine and equal volume of normal saline for preemptive analgesia,and the study group was given ketorolac tromethamine combined with dexmedetomidine for preemptive analgesia.The incidence of postoperative shivering,pain,perioperative stress hormone levels,and adverse reactions were compared between the two groups.Results The total incidence of postoperative chills in the study group(7.78%,7/90)was lower than that in the control group(22.22%,20/90),P<0.05.At 6,12,and 24 hours after operation,the visual analogue scale score in the study group was lower than that in the control group(t=6.97,6.97,2.06;all P<0.05).The levels of renin(Rn),cortisol(Cor)and adrenocorticotropic hormone(ACTH)in the two groups at 2 hours after operation(T1)and 24 hours after operation(T2)were higher than those before induction of anesthesia(T0),P<0.05.The Rn,Cor and ACTH in the control group at T2 were higher than those at T1(P<0.05),the Rn,Cor and ACTH in the control group at T2 were higher than those at T1(P<0.05),but the Rn,Cor and ACTH in the study group at T1 and T2 were lower than those in the control group(P<0.05).The incidence of nausea and vomiting in the study group was lower than that in the control group(χ^(2)=9.42,P<0.05).Conclusions Ketorolac tromethamine combined with dexmedetomidine preemptive analgesia for thoracoscopic radical resection of lung cancer can prevent postoperative shivering,enhance postoperative analgesic effect,inhibit perioperative stress response,and reduce adverse reactions.
作者
王铭
Wang Ming(Department of Anesthesiology,Nanyang Central Hospital,Nanyang 473005,China)
出处
《中国实用医刊》
2022年第14期74-78,共5页
Chinese Journal of Practical Medicine
关键词
酮咯酸氨丁三醇
右美托咪定
超前镇痛
寒战
疼痛
Ketorolac tromethamine
Dexmedetomidine
Preemptive analgesia
Shivering
Pain
作者简介
王铭,Email:30842360@qq.com。
