亢红妮

【摘 要】目的：探讨不同剂量右美托咪定复合舒芬太尼对普外科术后自控静脉镇痛的作用。方法：回顾性分析2019年4月至2021年4月70例普外科患者的临床资料，分为对照组（n=22）、低剂量组（n=25）、高剂量组（n=23），分别予以右美托咪定0μg/kg、1.5μg/kg、2.0μg/kg复合舒芬太尼1.0μg/kg进行术后自控静脉镇痛。监测术后各时间点的血流动力学指标，并记录三组达到理想镇静所需时间，采用视觉模拟量表（VAS）评估术后疼痛情况。结果：术后，低剂量组与高剂量组血流动力学明显较对照组平稳（P<0.05）。低剂量组与高剂量组达到理想镇静所需时间明显少于对照组（P<0.05），而高劑量组与低剂量组之间无明显差异（P>0.05）。低剂量组与高剂量组的VAS评分明显低于对照组（P<0.05），而高剂量组与低剂量组之间无明显差异（P>0.05）。结论：采取右美托咪定复合舒芬太尼进行术后自控静脉镇痛具有明显优势，且以1.5μg/kg右美托咪定复合舒芬太尼1.0μg/kg即可提供满意的镇静、镇痛效果，同时减少血流动力学波动。

【关键词】右美托咪定；舒芬太尼；自控静脉镇痛

Different doses of dexmedetomidine combined with sufentanil on patient-controlled intravenous analgesia after general surgery

Kang Hongni

Chencang Hospital of Baoji City， Baoji， Shaanxi， 721300， China

【Abstract】Objective： To investigate the effect of different doses of dexmedetomidine combined with sufentanil on patient-controlled intravenous analgesia after general surgery. Methods： A retrospective analysis of the clinical data of 70 general surgery patients from April 2019 to April 2021 was divided into control group （n=22）， low-dose group （n=25）， and high-dose group （n=23） ， Were given dexmedetomidine 0μg/kg， 1.5μg/kg， 2.0μg/kg and sufentanil 1.0μg/kg for postoperative self-controlled intravenous analgesia. The hemodynamic indicators at various time points after the operation were monitored， and the time required for the three groups to reach the ideal sedation was recorded. The visual analog scale （VAS） was used to evaluate the postoperative pain. Results： After operation， the hemodynamics of the low-dose group and the high-dose group were significantly more stable than that of the control group（P<0.05）. The time required to achieve ideal sedation between the low-dose group and the high-dose group was significantly less than that of the control group（P<0.05）， while there was no significant difference between the high-dose group and the low-dose group（P>0.05）. The VAS score of the low-dose group and the highdose group was significantly lower than that of the control group（P<0.05）， while there was no significant difference between the highdose group and the low-dose group（P>0.05）. Conclusion：Taking dexmedetomidine combined with sufentanil for postoperative patientcontrolled intravenous analgesia has obvious advantages， and 1.5μg/kg dexmedetomidine combined with sufentanil 1.0μg/kg can provide satisfactory sedation ， Analgesic effect， while reducing hemodynamic fluctuations.

【Key？Words】dexmedetomidine； sufentanil； patient-controlled intravenous analgesia

术后自控静脉镇痛的应用大大缓解了患者的疼痛，并促进恢复。阿片类药物是自控静脉镇痛的首选药物，具有良好的镇痛效应，但缺点是易引起一系列不良反应，甚至可能对呼吸循环产生严重影响。右美托咪定为高选择性α2受体激动剂，近年大量研究表明，阿片类药复合右美托咪定可有效提高自控静脉镇痛的安全有效性，且对右美托咪定的最佳剂量展开了广泛研究[1]。本研究探讨不同剂量右美托咪定复合舒芬太尼用于普外科术后自控静脉镇痛的效果，报道如下。……