术中泵注右美托咪啶对上腹部患者术后芬太尼自控静脉镇痛效果的影响

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1、中国医科大学硕士学位论文术中泵注右美托咪啶对上腹部患者术后芬太尼自控静脉镇痛效果的影响姓名：宫尚珍申请学位级别：硕士专业：麻醉学指导教师：原桂华201206·中文论著摘要·术中泵注右美托咪啶对上腹部患者术后芬太尼自控静脉镇痛效果的影响目的评价术中泵注右美托咪啶对上腹部患者术后芬太尼自控静脉镇痛效果的影响。方法行上腹部手术患者60例，ASA分级I～II级，随机分为2组(n=60)：D组于气管插管后静脉持续泵注小剂量右美托咪啶和对照组C组插管后持续泵注生理盐水。于手术结束前30min停止泵注右美托咪啶和生理盐水。手术结束即刻行患者自控静脉镇痛。记录2、4、6、12和

2、24小时：(1)镇痛效果：(2)镇静评分：(3)芬太尼用量、PCA有效按压次数：(4)不良反应如恶心、呕吐、瘙痒、心动过缓、低血压、镇静过度和呼吸抑制等。睦里钼，R1)与c组比较，D组术后2、4、6，12h内镇痛评分较低：2)镇静评分两组无差异：3)D组芬太尼用量、PCA有效按压次数减少(P

3、ffectofdexmedetomidineonpostoperativepatient--controlledintravenousanalgesia(PCIA)withfentanylafterupperabdomenoperationObjectiveToinvestigatetheeffectofcontinuebumpingDex(dexmedetomidine)onpostoperativePCIA(patiem-controlledintravenousanalgesia)withfentanylafterupperabdomenoperation

4、MaterialsandMethodsSixtypatients(ASAIorII)undergoingupperabdomenoperationwererandomlydividedinto2groups：Dexgroup(groupDex，n=30)andcontrolgroup(groupC，n=30)．PatientsinDexgroupwerereceived(O．5pg／kg。h)Dexandcontrolgroupwerereceivednormalsalinerespectivelyaftertrachealintubation．About30m

5、inutesbeforetheoperationfinished,Dexandnormalsalineweregopped．AllpatientsreceivedPCIA(patient-controlledinfusionanalgesia)device、jIritllfentanyl．PCIAsettingwasasfollows：backgroundinfusion3ml／h，bolusdose2mlandlockoutinterval10minutes．VASScore，Ramsaysedationscale(RSS)andcumulativefenta

6、nylconsumptionwererecordedat2,4，6，12and24hafterthebeginningofPCIA．Theincidenceadverseeventsofpostoperativenausea，vomitingandbradycardia,hypotension,sedationandrespiratorydepressionwasrecorded．ResultsComparedwithgroupC，VASandcumulativefentanylconsumptioningroupDexwasobviouslydecreased

7、(P<0．05)；RSSWassimily,PCAthenumberofeffectivecompressionsreduces．theincidenceofearly(upto24h)postoperativenausea，vomitinginDexgroupweredecreased(bunP>0．05)．Thetwogroupsdidnotoccurbradycardia,hypotension，excessivesedationandrespiratorydepression．2ConclusionDexwhichcontinuedbumpaddedto

8、intravenousf