摘要: |
目的:探讨右美托咪定对术后恶心呕吐(PONV)高危患者PONV发生的作用。方法:采用随机双盲对照研究法。纳入2015年11月至2016年5月择期行泌尿外科腹腔镜手术、女性且不吸烟的患者100例,随机分为:右美托咪定组和对照组。右美托咪定组患者在诱导前泵注右美托咪定0.6 μg/kg,术后加用右美托咪定3 μg/kg,其他麻醉处理同对照组。评价术后48 h内两组患者PONV严重程度、疼痛VAS评分,记录术后抗呕吐药物和其他镇痛药物使用情况。结果:93例患者完成研究,其中右美托咪定组47例,对照组46例。术后0~6 h,右美托咪定组患者PONV 0级例数较对照组多(37 vs 27,P<0.05)。右美托咪定组患者术后48 h内抗恶心呕吐药物使用比例较对照组降低(25.5% vs47.8%,P<0.05)。术后6~24 h、24~48 h,右美托咪定组患者VAS疼痛评分低于同时间段对照组(2.9±0.9 vs3.4±0.7,2.7±0.6 vs3.0±0.7,P<0.05)。结论:围手术期使用右美托咪定能够降低PONV高危患者术后早期PONV严重程度,减少术后抗恶心呕吐药物使用,并有助于改善术后镇痛效果。 |
关键词: 术后恶心呕吐 右美托咪定 腹腔镜手术 术后镇痛 |
DOI:10.12025/j.issn.1008-6358.2017.20161215 |
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Abstract: |
Objective:To explore the prophylactic efficiency of dexmedetomidine on postoperative nausea and vomiting (PONV) in highly susceptible patients. Methods:By using randomized and double blind controlled trial, 100 non smoking female patients receiving laparoscopic surgery were selected and randomly divided into dexmedetomidine group and control group. The dexmedetomidine group received 0.6 μg/kg dexmedetomidine before induction, and 3 μg/kg dexmedetomidine after surgery. The severity of PONV, the visual analogue scale (VAS)for pain scores, the use of rescued antiemetic and analgesic drugs were assessed for 48 h postoperatively. Results:There were 93 patients completed the study (47 cases in dexmedetomidine group and 46 cases in control group). The number of patients classified as PONV 0 in dexmedetomidine group was significantly more than that in the control group during the time interval 0 to 6 h postoperatively (37 vs 27, P<0.05). The percentage of the usage of antiemetic drugs within 48 hours in dexmedetomidine group was lower than that in control group(25.5% vs 47.8%,P<0.05). During the time intervals 6 to 24 h and 24 to 48 h, the pain scores were significantly lower in dexmedetomidine group compared with control group, 2.9±0.9 vs3.4±0.7 and 2.7±0.6 vs3.0±0.7, respectively (P<0.05). Conclusions:Dexmedetomidine used perioperatively might decrease the severity of PONV in early phase postoperatively in highly susceptible patients, and reduce the need for antiemetic drugs and improve the analgesia effects. |
Key words: postoperative nausea and vomiting dexmedetomidine laparoscopic surgery postoperative analgesia |