Sufentanil Combined With Dexmedetomidine for Analgesia After Hyperthermic Intraperitoneal Chemotherapy S
10.3969/j.issn.1009-6604.2018.01.002
- VernacularTitle:舒芬太尼复合右旋美托咪定用于腹腔热灌注化疗术后患者镇痛的效果观察
- Author:
Weixuan SHENG
1
;
Lei GUAN
Author Information
1. 首都医科大学附属世纪坛医院麻醉科
- Keywords:
Hyperthermic intraperitoneal chemotherapy;
Dexmedetomidine;
Sufentanil;
Patients controlled intravenous analgesia
- From:
Chinese Journal of Minimally Invasive Surgery
2018;18(1):6-10
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the analgesic efficiency of patients controlled intravenous analgesia ( PCIA) with sufentanil and dexmedetomidine after hyperthermic intraperitoneal chemotherapy ( HIPC) . Methods A total of 45 patients undergoing HIPC were randomly divided into 3 groups with 15 in each group .They received PCIA after operation with a background infusion rate of 2 ml/h, a loading dose of 2 ml, a lockout time of 15 min, and a liquid volume of 100 ml.The PCIA formulation in each group was as follows:group A (sufentanil 3.0 μg/h), group B (sufentanil 2.0 μg/h), and group C (sufentanil 2.0 μg/h +dexmedetomidine 4.0 μg/h).The VAS, Ramsay sedation scale, patient pressing times, and the adverse effects were recorded at 1 h (T1), 2 h (T2), 6 h (T3), 12 h (T4), 24 h (T5), and 48 h (T6) after surgery.Results The VAS scores of the group B were higher than those in the other two groups at T3-T6 time points [T3:(2.9 ±0.5) points vs.(3.5 ±0.8) points, q=3.600, P<0.05, (2.8 ±0.6) points vs.(3.5 ±0.8) points, q=4.200, P<0.05;T4:(2.4 ±0.6) points vs.(2.9 ±0.7) points, q=3.049, P<0.05;(2.3 ± 0.6) points vs.(2.9 ±0.7) points, q=3.659, P<0.05;T5:(1.9 ±0.6) points vs.(2.5 ±0.5) points, q=3.838, P<0.05;(1.8 ±0.7) points vs.(2.5 ±0.5) points, q=4.477, P<0.05;T6:(1.6 ±0.5) points vs.(2.0 ±0.4) points, q=3.303, P<0.05;(1.5 ±0.5) points vs.(2.0 ±0.4) points, q=4.129, P<0.05].The Ramsay scores of the group A were statistically higher than those of the group B at T5 and T6 [T5:(2.5 ±0.5) points vs.(2.1 ±0.5) points, q=2.893, P<0.05;T6: (2.3 ±0.5) points vs.(1.9 ±0.3) points, q=3.493, P<0.05].The Ramsay scores of the group B were statistically lower than those of the group C at T3-T6 [T3:(2.4 ±0.5) points vs.(3.1 ±0.7) points, q=4.477, P<0.05; T4: (2.2 ±0.4) points vs.(2.8 ± 0.7) points, q=4.243, P<0.05;T5:(2.1 ±0.5) points vs.(2.6 ±0.6) points, q=3.617, P<0.05;T6:(1.9 ±0.3) points vs.(2.4 ±0.5) points, q=4.367, P<0.05].The incidence of nausea and vomiting in the group A was higher than that in the group C [7 cases (46.7%) vs.1 case (6.7%),χ2 =4.261, P=0.039], while there were no differences between group B and C and between group A and B (P>0.05).The number of pressing times in the group B was more than that in the other two groups [(5.3 ±2.6) times vs.(8.4 ±4.2) times, q=3.662, P<0.05; (4.5 ±2.8) times vs.(8.4 ±4.2) times, q=4.608, P<0.05 ] . Conclusion Dexmedetomidine can reduce postoperative consumption of sufentanil in patients undergoing HIPC and decrease the incidence of nausea and vomiting .
