关键词: 右美托咪定, 镇痛, 病人控制 , 肺癌, 舒芬太尼

Abstract:

Objective To investigate the efficacy and safety of dexmedetomidine with different doses combined with sufentanil on patient-controlled intravenous analgesia （PCIA） after lung cancer radical surgery. Methods Ninety patients with ASA physical status Ⅱ or Ⅲ after lung cancer radical surgery were divided into three groups （30 cases in each group）. A group （sufentanil plus low-dose dexmedetomidine 0.06 μg?kg-1?h-1）; B group（sufentanil + mid-dose dexmedetomidine 0.06 μg?kg-1?h-1）;  C group（sufentanil plus high-dose dexmedetomidine 0.06 μg?kg-1 ?h-1）. The patients in three groups were given sufentanil 0.04 μg?kg-1?h-1. The VAS pain score, Ramsay sedation score, blood pressure, heart rate, breathing were recorded at 4 h, 8 h, 12 h, 16 h, 24 h and 48 h after surgery. The PCA press times, the satisfaction of patients, the occurrence of adverse reactions such as nausea, vomiting, itching, hypotension, bradycardia, respiratory depression and sedation excessive during the postoperative analgesia were recorded. Results Compared with A group, SBP, DBP and heart rate in B group, C group in all time points decreased with statistically significant（P<0.05）. Compared with B group, SBP, DBP and heart rate in C group in all time points decreased with statistically significant （P<0.05）. The postoperative VAS scores in three groups in all time points were less than 4. Group A took the top, followed by Group B, Group C. And the differences are statistically significant（P<0.05）. Ramsay scores at 4 h, 8 h, 12 h, 16 h, 24 h, Group C took the top, followed by Group B, Group A. And the differences are statistically significant（P<0.05）. There were no significant differences in PCA press times and the PCA press effective times in three groups（P>0.05）. The incidence of adverse effects in the group A and group C were significantly higher than those of group B（P<0.05）. The satisfaction of patients in the group B was significantly higher than those of group A and group C（P<0.05）. Conclusion The application of sufentanil（0.04 μg?kg-1?h-1）combined with mid-dose dexmedetomidine（0.08 μg?kg-1?h-1）on patient-controlled intravenous analgesia after lung cancer radical surgery can effectively improve analgesia and sedative effects and reduce the adverse reactions, improve the satisfaction of patients.

Key words: sufentanil, lung cancer, dexmedetomidine, patient-control, analgesia