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目的：观察围术期输注右美托咪啶对直肠癌患者术后镇痛及胃肠功能恢复的影响。方法：60 例择期行直肠癌根治术的患者随机分为三组：空白对照组（Ctr 组）不输注右美托咪啶；右美托咪啶组的患者入室后给予面罩吸氧并且泵注盐酸右美托咪啶，剂量为1 滋g/kg，10 min 输注完毕后开始麻醉诱导，大剂量组（LD 组）患者麻醉维持期间持续泵注右美托咪啶0.7 ug/kg/h；小剂量组（MD 组）泵注方法同LD 组，术中持续泵注剂量为0.1 ug/kg/h。手术结束后记录患者离开恢复室时（V1）、术后6 h（V2）、12 h （V3）、和24 h（V4）四个时间点的术后镇痛评分和胃肠功能恢复时间包括肠鸣音出现时间、排气时间、排便时间。结果：与其余两组比较，大剂量组患者各时间点的术后镇痛评分低于小剂量组和空白组，差异有统计学意义（P<0.05）。小剂量组患者V1 时疼痛评分较空白组减少（P<0.05），其余时间点术后疼痛评分两组比较无统计学差异（P>0.05）。大剂量组患者术后肠鸣音恢复时间较其余两组增加（P<0.05），排气、排便时间与其余两组比较无统计学差异（P>0.05）。小剂量组与空白组比较两组术后肠鸣音出现时间、排气时间和排便时间无统计学差异（P>0.05）。结论：围术期大剂量输注盐酸右美托咪啶可以改善患者术后疼痛，且不会抑制术后胃肠功能的恢复。

英文摘要:

Objective:To observe the effects of continous infusion of dexmedetomidine (Dex) to the recovery of post-operative gastrointestinal function.Methods:Sixty patients with carcinoma of rectum who were accepted colony surgery were divided into three groups randomly: control group (Ctr), and two Dex groups which received large dose (LD) and low dose(MD) Dex infusion respectively. The analgesia scores was recorded at four time points: when the patients left post-anesthesia care unit (V1); 6 h (V2),12 h (V3) and 24 h (V4) after operation, and the recovery time of gastrointestinal function including the borborygmus venting and defecation time was also detected.Results:The patients in the group LD had lower scores compared with the other groups after operation (P<0.05). Patients in group MD had lower scores in V1 point than group MD, but no difference was detectable at the other points. The borborygmus time in LD group was extended compared with the other groups and the rest had no difference among three groups (P>0.05).Conclusion:Large dose Dex infusion can improve the postoperative analgesia and wouldn't inhibit the recovery of gastrointestinal function.

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