Effect of Dexmedetomidine Combined with Sufentanil on Patient-controlled Intravenous Analgesia after Hysterectomy_West China Medical Journal

Authors：

XIE Linli ¹ ,  XIA Zongjing ¹ , HUANG Wei. ²

1. Department of Anesthesiology, Hospital of Tibet Autonomous Region to Chengdu Branch of West China Hospital; 2. West China Second Hospital; Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

XIA Zongjing, Email: gv23@qq.com

Keywords：

右美托咪啶; 舒芬太尼; 患者自控镇痛

DOI：

10.7507/1002-0179.20130122

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目的　观察右美托咪啶复合舒芬太尼用于经腹子宫全切术后患者自控静脉镇痛（PCIA）的效果。方法　2011年3月－2012年6月选择经腹子宫全切术患者90例，年龄39～68岁，体重48～72 kg，美国麻醉医师协会分级Ⅰ～Ⅱ级。采用随机数字表法，将患者随机分为3组，每组各30例。于手术结束即刻行PCIA。对照组（C组）采用舒芬太尼150 μg+昂丹司琼12 mg；S1组采用右美托咪定200 μg+舒芬太尼100 μg+昂丹司琼12 mg；S2组采用右美托咪定200 μg+舒芬太尼150 μg+昂丹司琼12 mg。3组均用生理盐水稀释至100 mL，负荷剂量均为舒芬太尼0.1 μg/kg，静脉镇痛泵背景输注速度2 mL/h，自控给药剂量0.5 mL，锁定时间15 min。记录术后6、12、24和48 h Ramsay镇静评分和视觉模拟评分（VAS），记录不良反应发生情况和患者对术后镇痛的满意度。结果　3组患者均能获得较好的镇痛效果。其中C组VAS评分较低，但恶心、呕吐、皮肤瘙痒发生率升高；与C组相比，Sl组和S2组Ramsay镇静评分升高，恶心、呕吐、皮肤瘙痒发生率降低，患者满意度升高。S1组患者满意度最高；S2组VAS评分最低。3组均未发生心动过缓、低血压、过度镇静和呼吸抑制。结论　右美托咪啶可增加经腹子宫全切术患者术后舒芬太尼自控静脉镇痛的效果，提高患者满意度，降低不良反应。

Citation： XIE Linli,XIA Zongjing,HUANG Wei.. Effect of Dexmedetomidine Combined with Sufentanil on Patient-controlled Intravenous Analgesia after Hysterectomy. West China Medical Journal, 2013, 28(3): 383-386. doi: 10.7507/1002-0179.20130122 Copy

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2.	Ebert TJ, Hall JE, Barney JA, et al. The effects of increasing plasma concentrations of dexmedetomidine in humans[J]. Anesthesiology, 2000, 93(2): 382-394.
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5.	周玉梅, 李璟, 涂远艳. 右美托咪定在气管内全身麻醉苏醒期拔管的应用[J]. 中国妇幼保健, 2010, 25(27): 4004-4006.
6.	Cooper L, Candiotti K, Gallagher C, et al. A randomized, controlled trial on dexmedetomidine for providing adequate sedation and hemodynamic control for awake, diagnostic transesophageal echocardiography[J]. J Cardiothorac Vasc Anesth, 2011, 25(2): 233-237.
7.	林玉婵, 刘卫江, 等. 182例机械通气患者Ramsay镇静评分的应用和护理[J]. 国际医药卫生报道, 2010, 16(18): 2302-2304.
8.	曹卉娟, 邢建民, 刘建平, 等. 视觉模拟评分法在症状类结局评价测量中的应用[J]. 中医杂志, 2009, 50(7): 600-602.
9.	Bradley C. Dexmedetomidine--a novel sedative for postoperative sedation[J]. Intensive Crit Care Nurs, 2000, 16(5): 328-329.
10.	Kamibayashi T, Maze M. Clinical uses of alpha2 -adrenergic agonists[J]. Anesthesiology, 2000, 93(5): 1345-1349.
11.	Riker RR, Shehabi Y, Bokesch PM, et al. Dexmedetomidine vs midazolam for sedation of critically ill patients: a randomized trial[J]. JAMA, 2009, 301(5): 489-499.
12.	Ostermann ME, Keenan SP, Seiferling RA, et al. Sadation in the intensive care unit:asystematic review[J]. JAMA, 2000, 283(11): 1451-1459.
13.	殷文渊, 邓羽霄, 杜唯佳, 等. 右旋美托咪定用于重症监护病房患者镇静的脑电研究[J]. 上海医学, 2009, 32(11): 944-947.
14.	Kunisawa T, Nagata O, Nagashima M, et al. Dexmedetomidine suppresses the decrease in blood pressure during anesthetic induction and blunts the cardiovascular response to tracheal intubation[J]. J Clin Anesth, 2009, 21(3): 194-199.

1. 　盛照志, 李清涛, 孙峰京. 盐酸右美托咪定注射液的稳定性研究[J]. 齐鲁药事, 2010, 29(2): 106-107.
2. 　Ebert TJ, Hall JE, Barney JA, et al. The effects of increasing plasma concentrations of dexmedetomidine in humans[J]. Anesthesiology, 2000, 93(2): 382-394.
3. 　Mcvey JD, Tobias JD. Dexmedetomidine and ketamine for sedation during spinal anesthesia in children[J]. Clin Anesth, 2010, 22(7): 538-545.
4. 　Al-Mustafa MM, Badran IZ, Abu-Ali HM, et al. Intravenous dexmedetomidine prolongs bupivacaine spinal analgesia[J]. Middle East J Anesthesiol, 2009, 20(2): 225-231.
5. 　周玉梅, 李璟, 涂远艳. 右美托咪定在气管内全身麻醉苏醒期拔管的应用[J]. 中国妇幼保健, 2010, 25(27): 4004-4006.
6. 　Cooper L, Candiotti K, Gallagher C, et al. A randomized, controlled trial on dexmedetomidine for providing adequate sedation and hemodynamic control for awake, diagnostic transesophageal echocardiography[J]. J Cardiothorac Vasc Anesth, 2011, 25(2): 233-237.
7. 　林玉婵, 刘卫江, 等. 182例机械通气患者Ramsay镇静评分的应用和护理[J]. 国际医药卫生报道, 2010, 16(18): 2302-2304.
8. 　曹卉娟, 邢建民, 刘建平, 等. 视觉模拟评分法在症状类结局评价测量中的应用[J]. 中医杂志, 2009, 50(7): 600-602.
9. 　Bradley C. Dexmedetomidine--a novel sedative for postoperative sedation[J]. Intensive Crit Care Nurs, 2000, 16(5): 328-329.
10. 　Kamibayashi T, Maze M. Clinical uses of alpha2 -adrenergic agonists[J]. Anesthesiology, 2000, 93(5): 1345-1349.
11. 　Riker RR, Shehabi Y, Bokesch PM, et al. Dexmedetomidine vs midazolam for sedation of critically ill patients: a randomized trial[J]. JAMA, 2009, 301(5): 489-499.
12. 　Ostermann ME, Keenan SP, Seiferling RA, et al. Sadation in the intensive care unit:asystematic review[J]. JAMA, 2000, 283(11): 1451-1459.
13. 　殷文渊, 邓羽霄, 杜唯佳, 等. 右旋美托咪定用于重症监护病房患者镇静的脑电研究[J]. 上海医学, 2009, 32(11): 944-947.
14. 　Kunisawa T, Nagata O, Nagashima M, et al. Dexmedetomidine suppresses the decrease in blood pressure during anesthetic induction and blunts the cardiovascular response to tracheal intubation[J]. J Clin Anesth, 2009, 21(3): 194-199.

West China Medical Journal

Effect of Dexmedetomidine Combined with Sufentanil on Patient-controlled Intravenous Analgesia after Hysterectomy

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