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; 患者自控鎮痛

DOI：

10.7507/1002-0179.20130122

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

目的　觀察右美托咪啶復合舒芬太尼用于經腹子宮全切術后患者自控靜脈鎮痛（PCIA）的效果。方法　2011年3月－2012年6月選擇經腹子宮全切術患者90例，年齡39～68歲，體重48～72 kg，美國麻醉醫師協會分級Ⅰ～Ⅱ級。采用隨機數字表法，將患者隨機分為3組，每組各30例。于手術結束即刻行PCIA。對照組（C組）采用舒芬太尼150 μg+昂丹司瓊12 mg；S1組采用右美托咪定200 μg+舒芬太尼100 μg+昂丹司瓊12 mg；S2組采用右美托咪定200 μg+舒芬太尼150 μg+昂丹司瓊12 mg。3組均用生理鹽水稀釋至100 mL，負荷劑量均為舒芬太尼0.1 μg/kg，靜脈鎮痛泵背景輸注速度2 mL/h，自控給藥劑量0.5 mL，鎖定時間15 min。記錄術后6、12、24和48 h Ramsay鎮靜評分和視覺模擬評分（VAS），記錄不良反應發生情況和患者對術后鎮痛的滿意度。結果　3組患者均能獲得較好的鎮痛效果。其中C組VAS評分較低，但惡心、嘔吐、皮膚瘙癢發生率升高；與C組相比，Sl組和S2組Ramsay鎮靜評分升高，惡心、嘔吐、皮膚瘙癢發生率降低，患者滿意度升高。S1組患者滿意度最高；S2組VAS評分最低。3組均未發生心動過緩、低血壓、過度鎮靜和呼吸抑制。結論　右美托咪啶可增加經腹子宮全切術患者術后舒芬太尼自控靜脈鎮痛的效果，提高患者滿意度，降低不良反應。

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

1.	盛照志, 李清濤, 孫峰京. 鹽酸右美托咪定注射液的穩定性研究[J]. 齊魯藥事, 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, 涂遠艷. 右美托咪定在氣管內全身麻醉蘇醒期拔管的應用[J]. 中國婦幼保健, 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.	林玉嬋, 劉衛江, 等. 182例機械通氣患者Ramsay鎮靜評分的應用和護理[J]. 國際醫藥衛生報道, 2010, 16(18): 2302-2304.
8.	曹卉娟, 邢建民, 劉建平, 等. 視覺模擬評分法在癥狀類結局評價測量中的應用[J]. 中醫雜志, 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.	殷文淵, 鄧羽霄, 杜唯佳, 等. 右旋美托咪定用于重癥監護病房患者鎮靜的腦電研究[J]. 上海醫學, 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, 李清濤, 孫峰京. 鹽酸右美托咪定注射液的穩定性研究[J]. 齊魯藥事, 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, 涂遠艷. 右美托咪定在氣管內全身麻醉蘇醒期拔管的應用[J]. 中國婦幼保健, 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. 　林玉嬋, 劉衛江, 等. 182例機械通氣患者Ramsay鎮靜評分的應用和護理[J]. 國際醫藥衛生報道, 2010, 16(18): 2302-2304.
8. 　曹卉娟, 邢建民, 劉建平, 等. 視覺模擬評分法在癥狀類結局評價測量中的應用[J]. 中醫雜志, 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. 　殷文淵, 鄧羽霄, 杜唯佳, 等. 右旋美托咪定用于重癥監護病房患者鎮靜的腦電研究[J]. 上海醫學, 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

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content