神经药理学报

神经药理学报 ›› 2022, Vol. 12 ›› Issue (6): 30-34.DOI: 10.3969/j.issn.2095-1396.2022.06.005

• 研究论文 • 上一篇    下一篇

右美托咪定复合舒芬太尼及地佐辛PCIA 对 腹腔镜全子宫切除术患者睡眠质量的影响

戴庆玲   

  1. 泰和县中医院，泰和，343700，中国
  • 出版日期:2022-12-26 发布日期:2023-08-30
  • 通讯作者: 戴庆玲，主治医师；E-mail：thqd12@163.com
  • 基金资助:
    赣州市指导性科技计划项目（No.GZ2020ZSF447）

Effect of Dexmedetomidine Combined with Sufentanil and Dezocine PCIA on Sleep Quality in Patients Undergoing Laparoscopic Total Hysterectomy

DAI Qing-ling   

  1. Taihe Hospital of Traditional Chinese Medicine，Taihe，343700，China
  • Online:2022-12-26 Published:2023-08-30

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摘要：

目的：探讨右美托咪定复合舒芬太尼及地佐辛自控静脉镇痛（patient-controlled intravenous analgesia， PCIA）对腹腔镜全子宫切除术患者睡眠质量的影响。方法：选取2020 年1 月~2022 年12 月在泰和县中医院行 腹腔镜全子宫切除术患者80 例，随机分为对照组（n=40）和观察组（n=40）；两组术后均行PCIA，持续镇痛48 h， 观察组配方为右美托咪定5 μg·kg-1+ 地佐辛0.3 mg·kg-1+ 舒芬太尼1.5 μg·kg-1+ 昂丹司琼3 mg，对照组配方 为地佐辛0.3 mg·kg-1+ 舒芬太尼1.5 μg·kg-1+ 昂丹司琼3 mg。记录两组术后疼痛视觉模拟（visual analogue scale，VAS）评分、术后镇痛泵有效按压次数、实际按压次数、补救镇痛率和不良反应情况；于术前、术后1 d 和 术后3 d 行匹兹堡睡眠指数量表（pittsburgh sleep quality index，PSQI）和阿森失眠量表（athens insomnia scale， AIS）的评定。结果：观察组术后6~24 h VAS 评分显著低于对照组（P<0.05）。与对照组比较，观察组镇痛泵有 效按压次数、实际按压次数减少（P<0.05），补救镇痛率降低（P<0.05）。观察组术后恶心、呕吐发生率显著低于对 照组（P<0.05）。两组术后1 d、3 d 的PSQI 评分和AIS 评分相比术前显著增高（P<0.05）；相比对照组，观察组术 后各时间点PSQI 评分和AIS 评分显著降低（P<0.05）；且与对照组的37.50% 相比，观察组术后睡眠障碍发生率 （17.50%）显著降低（P<0.05）。结论：右美托咪定复合舒芬太尼及地佐辛应用于腹腔镜全子宫切除术后PCIA，不 仅能够使镇痛效果提升，还有助于患者术后睡眠质量的改善。

关键词: 全子宫切除术, 自控静脉镇痛, 右美托咪定, 地佐辛, 舒芬太尼, 睡眠质量

Abstract:

Objective：To investigate the effect of dexmedetomidine combined with sufentanil and dezocine patient-controlled intravenous analgesia （PCIA） on sleep quality in patients undergoing laparoscopic hysterectomy. Methods：80 patients undergoing laparoscopic total hysterectomy in our hospital from January 2020 to December 2022 were randomly divided into control group （n=40） and observation group （n=40）. PCIA was performed in both groups after operation，and continuous analgesia was performed for 48 hours. The observation group was given dexmedetomidine 5 μg·kg-1+dezocine 0.3 mg·kg-1+sufentanil 1.5 μg·kg-1+granisetron 3 mg，and the control group was given dezocine 0.3 mg·kg-1+sufentanil 1.5 μg·kg-1 + granisetron 3 mg. The visual analogue scale （VAS） score，effective pressing times，actual pressing times，remedial analgesia rate and adverse reactions of the two groups were recorded. The pittsburgh sleep quality index （PSQI） and athens insomnia scale （AIS） were assessed before operation，1 day and 3 days after operation. Results：The VAS score of the observation group was significantly lower comparing with the control group（P<0.05）. Compared with the control group，the effective pressing times and actual pressing times of analgesia pump in the observation group decreased （P<0.05），and the remedial analgesia rate decreased （P<0.05）. The incidence of postoperative nausea and vomiting in the observation group was significantly lower comparing with the control group （P<0.05）. The PSQI score and AIS score of the two groups were significantly higher than those before operation（ P<0.05）. Compared with the control group， the PSQI score and AIS score of the observation group were significantly lower at each time point after operation （P<0.05）. The incidence of postoperative sleep disorders in the observation group was 17.50 %，which was significantly lower than 37.50 % in the control group（P<0.05）. Conclusion：Dexmedetomidine combined with sufentanil and dezocine in PCIA after laparoscopic total hysterectomy can provide good analgesic effect，and improve postoperative sleep quality.

Key words: total hysterectomy, patient-controlled intravenous analgesia, dexmedetomidine, dezocine, sufentanil, sleep quality