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| Efficacy of different doses of Dexmedetomidine combined with Sufentanil for patient-controlled intravenous analgesia after spinal surgery |
| LIU Ying1 ZHANG Yunqiong1 ZHAO Zeyu2 WANG Zhongsheng1 GUO Yilin1 |
1.Department of Anesthesiology, Luzhou Hospital of Traditional Chinese Medicine, Sichuan Province, Luzhou 646000, China;
2.Department of Anesthesiology, Sichuan 81 Rehabilitation Center, Sichuan Province, Chengdu 611135, China |
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Abstract Objective To evaluate the efficacy of different doses of Dexmedetomidine (Dex) combined with Sufentanil for patient-controlled intravenous analgesia after spinal surgery. Methods 120 cases of patients with ASA Ⅰ-Ⅲ grade underwent elective spinal surgery with general anesthesia in Luzhou Traditional Chinese Medicine Hospital from January 2015 to December 2016 were selected, and randomly divided into group A, group B and group C, each gorup had 40 cases. The postoperative intravenous analgesia formula: Sufentanil 0.05 μg/(kg·h) in group A, Sufentanil 0.03 μg/ (kg·h) + Dex 0.05 μg/(kg·h) in group B, and Sufentanil 0.03 μg/(kg·h) + Dex 0.08 μg/(kg·h) in group C, and all added to normal saline to 100 mL, loading dose of 3 mL, background dose of 2 mL/h, PCA dose of 1 mL and locking time of 15 min. The VAS and Ramsay scores at the time points of 2, 4, 6, 12, 24 h after surgery, PCIA pressing times, the dosages of Sufentanil and complications such as nausea and vomiting, hypotension, bradycardia, respiratory depression in the three groups were recorded. Results The VAS and Ramsay scores at different time points in the three groups were tatistically significant differences (P < 0.01). Compared with group A, the VAS scores at the time points of 4, 6, 12, 24 h after surgery in group B and group C were decreased (P < 0.01), and the VAS scores of group C were lower than those of group B (P < 0.05). Compared with group A, the Ramsay scores at the time points of 4, 6, 12, 24 h in group B and group C were increased (P < 0.05), and the Ramsay scores of group C were higher than those of group B (P < 0.05). The PCA pressing times and the dosage of Sufentanil of group B and group C were less than those of group A (P < 0.01), which of group C were less than those of group B（P < 0.01). The incidence of nausea and vomiting of group A was significantly higher than that of group B and group C (P < 0.05). Conclusion Dex combined with Sufentanil for patient-controlled intravenous analgesia after spinal surgery has good effects, and Dex can enhance the analgesic effect and reduce dosage and adverse reaction of opioids.
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[1] 刘伟，陈高峰，岳生，等.右美托咪定复合不同剂量舒芬太尼对脊柱手术患者术后镇痛的影响[J].临床麻醉学杂志，2016，32（3）：265-267.
[2] 初紫晶，刘艳.间歇式充气加压仪预防脊柱手术后深静脉血栓有效性的Meta分析[J].中华现代护理杂志，2016， 22（26）：3775-3778.
[3] 黄红，江恬.舒芬太尼对中老年胸科手术患者麻醉苏醒的影响[J].重庆医学，2011，40（17）：1749-1750.
[4] 周岩，王蓓，宋一楠，等.小剂量右美托咪定对妇科腹腔镜手术患者术后恶心呕吐发生的影响[J].中华麻醉学杂志，2016，36（5）：524-527.
[5] 赵泽宇，刘建波，张蓉，等.右美托咪定对脑瘫患儿七氟醚麻醉苏醒期躁动的影响[J].中华麻醉学杂志，2013，33（6）：676-679.
[6] Ye WD，Hu ZY，Jin XM，et al. Effects of dexmedetomidine for retrobulbar anesthesia in orbital ball implants after enucleation surgery [J]. Indian J Ophthalmol，2015，63（9）：704-709.
[7] 刘建波，谢位燕，赵泽宇.右美托咪定复合舒芬太尼用于脑瘫患儿术后静脉自控镇痛的效果观察[J].实用医学杂志，2014，30（8）：1303-1305.
[8] 李晓勤，顾楠，吕琳，等.超声引导下外侧膝眼进针膝关节腔注射与盲法膝关节腔注射的对照研究[J].中国疼痛医学杂志，2016，22（11）：838-841.
[9] 陶勇，叶勇，汪娜，等.不同剂量氢吗啡酮用于老年患者术后硬膜外镇痛的临床研究[J].检验医学与临床，2015， 12（20）：3006-3008.
[10] Ciftci T，Erbatur S，Ak M. Comparison of the effects of dexmedetomidine and remifentanil on potential extreme haemodynamic and respiratory response following mask ventilation and laryngoscopy in patients with mandibular fractures [J]. Eur Rev Med Pharmacol Sci，2015，19（22）：4427-4433.
[11] Vincent J，Thawley Kenneth J，Drobat Z. Assessment of dexmedetomidine and other agents for emesis induction in cats：43 cases（2009-2014）[J].J Am Veter Med Assoc，2015，247（12）：1415-1418.
[12] 姜徽，李元海，周磊，等.不同镇痛方法对老年食管癌患者术后疼痛及早期认知功能的影响[J].临床麻醉学杂志，2016，3（5）：472-475.
[13] Greening A，Mathews L，Blair J. Apparent dexmedetomidine-induced polyuric syndrome in an achondroplastic patient undergoing posterior spinal fusion [J]. Anesth Analg，2011，113（6）：1381-1383.
[14] 史成梅，周永德，徐懋，等.小剂量右美托咪啶复合舒芬太尼清醒镇静术在老龄患者多发肠息肉切除术中的应用[J].中华医学杂志，2016，96（43）：3474-3478.
[15] Chen JY，Li N，Xu YQ. Single shot adductor canal block for postoperative analgesia of pediatric patellar dislocation surgery：a case-series report [J]. Medicine，2015，94（48）：e2217.
[16] 张亮.右美托咪啶用药安全性的研究进展[J].重庆医学，2013，42（9）：1066-1069.
[17] 王庭国，彭俊旭，桑軼娜，等.右美托咪啶对老年高血压患者全身麻醉诱导期血流动力学的影响[J].中国医药科学，2015，5（19）：169-171，182.
[18] 吴多志，董振明.右美托咪定在高龄手术患者麻醉中应用的研究进展[J].中国医药导报 ，2016，13（21）：70-73.
[19] 张作强，杜娜.不同剂量右美托咪啶对高血压患者全麻拔管期的影响[J].中国医药科学，2015，5（24）：100-102， 140.
[20] 刘英，张运琼，魏开明.右美托咪定两种给药方式用于无痛纤维结肠镜检查术的效果[J].中国医药导报，2015， 12（25）：86-89，136.
[21] 吴晓丹，陈彦青，邹聪华.右美托咪啶与咪达唑仑复合舒芬太尼用于肝癌微波治疗术患者麻醉效果的比较[J].中华麻醉学杂志，2014，34（z1）：7-9.
[22] 胡志超，孔莉，许鹏程，等.不同剂量右美托咪定镇静程度及顺行性遗忘作用研究[J].国际麻醉学与复苏杂志，2015，36（7）：582-586. |
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