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右美托咪定联合舒芬太尼用于开胸术后静脉镇痛的效果:一项随机对照临床研究。

Effect of Dexmedetomidine combined with sufentanil for post- thoracotomy intravenous analgesia:a randomized, controlled clinical study.

作者信息

Dong Chun-Shan, Zhang Jun, Lu Qiang, Sun Peng, Yu Jun-Ma, Wu Chao, Sun Hao

机构信息

Department of Anesthesiology, Third affiliation hospital of Anhui Medical University, Hefei huaihe road No. 390, Hefei, 230061, China.

出版信息

BMC Anesthesiol. 2017 Mar 1;17(1):33. doi: 10.1186/s12871-017-0324-4.

Abstract

BACKGROUND

Few studies have investigated the use of dexmedetomidine in patient-controlled intravenous analgesia (PCIA) after thoracic surgery. This study to evaluate the effect of dexmedetomidine combined with sufentanil for PCIA after thoracotomy under general anaesthesia.

METHODS

Ninety-seven adults patients scheduled for thoracotomy surgery. All two groups received PCIA with either sufentanil alone (control group) or combining dexmedetomidine with sufentanil (dexmedetomidine group). Hemodynamic measurements, visual analog scale (VAS) scores at rest and at coughing, Ramsay sedation score (RSS), analgesic consumption, and postoperative nausea and vomiting (PONV) as well as drug-related adverse effects were compared at 2, 6, 12, 24, 36 and 48 h postoperatively.

RESULTS

In the patients of the dexmedetomidine group, compared to the control group, the pain scores at rest or at coughing during 48 h postoperatively were lower (P < 0.001), the sedation scores were lower, the consumption of sufentanil and rescue meperidine were lower, and the number of episode of moderate PONV was three times lower. No signs of toxicity or local complications were observed. There was a non-significant trend for a lower HR and BP in the dexmedetomidine group vs.

CONCLUSION

The combining dexmedetomidine with sufentanil for post-thoracotomy PCIA can improve pain control together with the decrease in sufentanil requirements, and improve postoperative patient's satisfaction compared with sufentanil alone in PCIA.

TRIAL REGISTRATION

This trial was retrospectively registered on 27 April 2016 at the Chinese Clinical Trial Register (number: ChiCTR-ONC-16008376 ).

摘要

背景

很少有研究调查右美托咪定在胸科手术后患者自控静脉镇痛(PCIA)中的应用。本研究旨在评估右美托咪定联合舒芬太尼用于全身麻醉下开胸术后PCIA的效果。

方法

97例计划行开胸手术的成年患者。两组均接受PCIA,一组单独使用舒芬太尼(对照组),另一组将右美托咪定与舒芬太尼联合使用(右美托咪定组)。比较术后2、6、12、24、36和48小时的血流动力学指标、静息和咳嗽时的视觉模拟评分(VAS)、Ramsay镇静评分(RSS)、镇痛药物消耗量、术后恶心呕吐(PONV)以及药物相关不良反应。

结果

与对照组相比,右美托咪定组患者术后48小时内静息或咳嗽时的疼痛评分更低(P<0.001),镇静评分更低,舒芬太尼和急救哌替啶的消耗量更低,中度PONV的发作次数低三倍。未观察到毒性迹象或局部并发症。右美托咪定组的心率和血压有降低的趋势,但无统计学意义。

结论

与单独使用舒芬太尼进行PCIA相比,右美托咪定联合舒芬太尼用于开胸术后PCIA可更好地控制疼痛,减少舒芬太尼用量,提高患者术后满意度。

试验注册

本试验于2016年4月27日在中国临床试验注册中心进行回顾性注册(编号:ChiCTR-ONC-16008376)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b4b6/5333470/ef8ef0992100/12871_2017_324_Fig1_HTML.jpg

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