CAJ | 학술논문

目的观察右旋美托咪啶(dexmedetomidine,Dex)联合芬太尼用于腹腔镜术后的镇痛效果.方法75例ASA I-Ⅱ级于全身麻醉下行腹腔镜下手术的患者,术后行患者自控静脉镇痛(PCIA),随机分成3组(n=25).组1：芬太尼1.0 mg+恩丹西酮4 mg；组2：芬太尼0.5 mg+Dex 100μg+恩丹西酮4 mg；组3：芬太尼0.5 mg+Dex 200μg+恩丹西酮4 mg.分别记录术后2、8、12、24、48 h的动/静疼痛视觉模拟评分(VAS),不良作用的发生率.结果组1,组3镇痛效果均满意,需追加镇痛药的比率较组2低(P<0.05)；组2、组3的PONV发生率明显低于组1(P<0.05).结论 Dex用于腹腔镜术后静脉镇痛安全有效,不仅可减少阿片类药物的剂量,还可减少恶心呕吐的发生.
목적관찰우선미탁미정(dexmedetomidine,Dex)연합분태니용우복강경술후적진통효과.방법75례ASA I-Ⅱ급우전신마취하행복강경하수술적환자,술후행환자자공정맥진통(PCIA),수궤분성3조(n=25).조1：분태니1.0 mg+은단서동4 mg；조2：분태니0.5 mg+Dex 100μg+은단서동4 mg；조3：분태니0.5 mg+Dex 200μg+은단서동4 mg.분별기록술후2、8、12、24、48 h적동/정동통시각모의평분(VAS),불량작용적발생솔.결과조1,조3진통효과균만의,수추가진통약적비솔교조2저(P<0.05)；조2、조3적PONV발생솔명현저우조1(P<0.05).결론 Dex용우복강경술후정맥진통안전유효,불부가감소아편류약물적제량,환가감소악심구토적발생.
Objective To observe the effects of combining dexmedetomidine (Dex) and fentanyl for patient-controlled intravenous analgesia ( PCSA) in laparoscopic surgery. Methods Seventy-five ASA I-Ⅱ patients underwent laparoscopic surgery and postoperative PCIA were randomly divided into 3 groups (n=25). Group 1 (Fentanyl 1.0 mg plus Ondansetron 4 mg), Group 2 (Fentanyl 0.5 mg plus Dex 100 μg and Ondansetron 4 mg) and Group 3 (Fentanyl 0.5 mg plus Dex 200 μg and Ondansetron 4 mg). The visual analog scale (VAS) at rest and movement to assess the analgesia effects after 2, 8, 12, 24, 48 h of the operations, and the occurrence of postoperative nausea and vomiting (PONV) were observed. Results The analgesia effects were satisfied in group 1 and 3, the demanding of supernumerary analgesic were fewer than the group 2 (P<0.05). The occurrence of PONV in group 2 and group 3 were lower than group 1(P<0.05). Results The addition of Dex to PCIA resulted in superior analgesia, significant fentanyl sparing, less fentanyl-induced PONV.