Efficacy and safety of sufentanil combined with flurbiprofen axetil and dexmedetomidine in patient-controlled intravenous analgesia after open radical surgery for colorectal cancer
- Author:
- No author available
- Journal Title:
- China Medicine
- Issue:
- 12
- DOI:
- 10.3760/j.issn.1673-4777.2022.12.013
- Key Word:
- 结直肠癌;舒芬太尼;氟比洛芬酯;右美托咪定;患者静脉自控镇痛;加速康复
Abstract： 目的 观察舒芬太尼联合氟比洛芬酯和右美托咪定用于开腹结直肠癌根治术后患者静脉自控镇痛(PCIA)的有效性和安全性.方法 收集2016年1月至2018年12月在四川大学华西医院行开腹结直肠癌根治术并于术后行PCIA的406例患者的临床资料进行回顾性分析.根据患者术后PCIA用药方案的不同,分为舒芬太尼联合氟比洛芬酯和右美托咪定镇痛组(PCIA-FDS组,221例)和舒芬太尼联合曲马多镇痛组(PCIA-ST组,185例).2组间比较的主要结局指标为患者术后48 h舒芬太尼用量,次要结局指标包括术后24、48 h静息和活动疼痛视觉模拟量表(VAS)评分、恶心呕吐发生率、首次肛门排气时间、尿管拔除时间、术后住院天数和患者满意度.结果 通过多元线性回归分析确认不同镇痛方案对术后48 h舒芬太尼用量(术后疼痛)具有较高的影响强度.PCIA-FDS组患者术后48 h舒芬太尼用量明显少于PCIA-ST组[(63±11)μg比(121±21)μg],差异有统计学意义(t=29.708,P<0.001).PCIA-FDS组患者术后24、48 h静息和活动疼痛VAS评分均明显低于PCIA-ST组,差异均有统计学意义(均P<0.001).PCIA-FDS组术后48 h恶心呕吐发生率[4.1％(9/221)比10.8％(20/185)]、首次肛门排气时间、尿管拔除时间、术后住院天数均低于/短于PCIA-ST组,患者满意度评分高于PCIA-ST组,差异均有统计学意义(均P<0.05).结论 舒芬太尼联合氟比洛芬酯和右美托咪定PCIA可明显减少开腹结直肠癌根治术患者术后舒芬太尼用量,改善患者术后疼痛VAS评分,促进胃肠功能恢复,缩短住院时间,可能是开腹结直肠手术加速康复外科理想的镇痛方式.
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