肿瘤药学2018，Vol.8Issue(6)：889-892,923,5.DOI:10.3969/j.issn.2095-1264.2018.06.12
右美托咪定辅助舒芬太尼对胃癌术后静脉镇痛的剂量分析及对患者认知功能的影响
The Dose Analysis and Effect of Dexmedetomidine Assisted Sufentanil on Intravenous Analgesia after Gastric Cancer Surgery ★
李艳琼 1赵建华 1魏磊 1杨芬 1吴一帆1
作者信息
- 1. 南京医科大学附属苏州市立医院麻醉科,江苏 苏州,215000
- 折叠
摘要
Abstract
Objective To explore the effects of different dosages of dexmedetomidine supplementation after gastric cancer surgery on in-travenous analgesia and postoperative cognitive dysfunction of patients. Methods A total of 118 cases of gastric cancer resection in our hos-pital were selected as the research subjects. According to the treatment methods, the patients were divided into the control group and the ob-servation group. The control group was given sufentanil, named as group A, with a dose of 3.0 μg·kg-1. Patients in the observation group were treated with sufentanil and dexmedetomidine, also named as group B. The group B was divided into three subgroups according to the dosage of dexmedetomidine. Group B1(dexmedetomidine 3.0 μg·kg-1 + sufentanil 1.0 μg·kg-1); group B2(dexmedetomidine 3.5 μg·kg-1 + sufentanil 1.5 μg·kg-1); group B3(dexmedetomidine 3.0 μg·kg-1 + sufentanil 2.0 μg·kg-1). The visual analogue scale (VAS) scores, Ramsay sedation scores and the changes of postoperative cognitive impairment in groups were compared. The changes of inflammatory cytokines were also observed and compared before and after the operation. The incidence of adverse reactions in all groups was compared. Results There was no significant difference in analgesic score between group A and B (P>0.05). The sedative score of the patients in group B was significantly higher than that in group A. What’s more, the sedative effect of group B2 was the best (P<0.05). Group B2 also had significantly less cogni-tive dysfunction cases than group B1 and B3(P<0.05). Before the operation, there was no significant difference in the level of each inflam-matory cytokine between groups (P>0.05). But after operation, the levels of IL-6 and TNF-α in both group A and B increased significantly, and the level of IL-10 decreased significantly. The increase of IL-6 and TNF-α levels and the decrease of IL-10 level were greater in group B than in group A. Moreover, the levels of inflammatory cytokines had the most improvement in group B2(P<0.05). As for the incidence of adverse reactions, it turned out as group B3 > group A > group B1 > group B2. Group B3 had the highest incidence of adverse reactions (P<0.05). Conclusion Dexmedetomidine combined with sufentanil had a good effect on postoperative intravenous analgesia for gastric can-cer patients. The best dose could be chosen as dexmedetomidine 3.5 μg·kg-1 plus sufentanil 1.5 μg·kg-1.关键词
右美托咪定/舒芬太尼/镇痛/不同剂量/认知功能障碍Key words
Dexmedetomidine/Sufentanil/Analgesic/Different doses/Cognitive dysfunction分类
医药卫生引用本文复制引用
李艳琼,赵建华,魏磊,杨芬,吴一帆..右美托咪定辅助舒芬太尼对胃癌术后静脉镇痛的剂量分析及对患者认知功能的影响[J].肿瘤药学,2018,8(6):889-892,923,5.
