文章摘要
庄凯峰,蔡清香,陈 鸶,黄延逵,马武华.右美托咪定复合羟考酮在腹腔镜下直肠癌根治术患者术后镇痛中的作用及对应激反应和胃肠功能恢复的影响[J].,2022,(6):1084-1087
右美托咪定复合羟考酮在腹腔镜下直肠癌根治术患者术后镇痛中的作用及对应激反应和胃肠功能恢复的影响
Effect of Dexmedetomidine Combined with Oxycodone on Postoperative Analgesia and the Effect on Stress Response and Gastrointestinal Function Recovery in Patients Undergoing Laparoscopic Radical Resection of Rectal Cancer
投稿时间:2021-08-07  修订日期:2021-08-30
DOI:10.13241/j.cnki.pmb.2022.06.018
中文关键词: 右美托咪定  羟考酮  直肠癌  镇痛  应激反应  胃肠功能
英文关键词: Dexmedetomidine  Oxycodone  Rectal cancer  Analgesia  Stress response  Gastrointestinal function
基金项目:广东省科学技术厅自筹经费类科技计划项目(2017ZC0155)
作者单位E-mail
庄凯峰 广州中医药大学第一附属医院麻醉科 广东 广州 510000 kaifeng6500@163.com 
蔡清香 广州中医药大学第一附属医院麻醉科 广东 广州 510000  
陈 鸶 广州中医药大学第一附属医院麻醉科 广东 广州 510000  
黄延逵 广州中医药大学第一附属医院麻醉科 广东 广州 510000  
马武华 广州中医药大学第一附属医院麻醉科 广东 广州 510000  
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中文摘要:
      摘要 目的:观察腹腔镜下直肠癌根治术患者应用右美托咪定复合羟考酮在术后镇痛中的作用以及对应激反应和胃肠功能恢复的影响。方法:纳入我院2018年1月~2019年12月收治的腹腔镜下直肠癌根治术患者100例,根据随机数字表法分为对照组(n=50,术后镇痛选用羟考酮)和研究组(n=50,术后镇痛选用右美托咪定复合羟考酮)。观察术后镇痛、镇静情况,分析术后不同时间点应激反应指标变化情况,观察两组术后胃肠功能恢复情况和不良反应情况。结果:两组术后不同时间点(3 h、12 h、24 h)Ramsay镇静评分、视觉模拟量表(VAS)评分随着时间的延长而降低(P<0.05)。研究组术后不同时间点(3 h、12 h、24 h)VAS评分均低于对照组,Ramsay镇静评分则高于对照组(P<0.05)。两组肠鸣音出现时间、排气时间、排便时间组间对比差异无统计学意义(P>0.05)。两组术后不同时间点(3 h、12 h、24 h)的白介素-6(IL-6)、皮质醇(Cor)、去甲肾上腺素(NE)水平先升高后降低(P<0.05)。研究组术后12 h和术后24 h的IL-6、Cor、NE水平低于对照组(P<0.05)。两组不良反应发生率组间对比无差异(P>0.05)。结论:右美托咪定复合羟考酮应用于腹腔镜下直肠癌根治术患者,可获得良好的镇静镇痛效果,同时还可减轻机体应激反应,且不影响机体胃肠功能恢复,安全有效。
英文摘要:
      ABSTRACT Objective: To investigate the effect of dexmedetomidine combined with oxycodone on postoperative analgesia and the effect on stress response and gastrointestinal function recovery in patients undergoing laparoscopic radical resection of rectal cancer. Methods: 100 patients who underwent laparoscopic radical resection of rectal cancer in our hospital from January 2018 to December 2019 were selected, they were divided into control group(n=50, oxycodone for postoperative analgesia) and study group (n=50, dexmedetomidine combined with oxycodone for postoperative analgesia) by random digital table method. The postoperative analgesia and sedation were observed. The changes of stress response indexes at different time points after operation were analyzed, and the recovery of gastrointestinal function and adverse reactions were observed in the two groups. Results: The Ramsay sedation score, visual analogue scale (VAS) score of the two groups decreased with the time extension at different time points (3 h, 12 h and 24 h) (P<0.05). VAS score of the study group was lower than that of the control group at different time points (3 h, 12 h, 24 h), and Ramsay sedation score was higher than that of the control group(P<0.05). There were no significant differences in bowel sound occurrence time, exhaust time and defecation time between the two groups (P>0.05). The levels of interleukin-6 (IL-6), cortisol (Cor) and norepinephrine (NE) in the two groups at different time points after operation (3 h, 12 h and 24 h) were firstly increased and then decreased (P<0.05). The levels of IL-6, Cor and NE of the study group at 12 h after operation and 24 h after operation were lower than those of the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion: The application of dexmedetomidine combined with oxycodone in patients after laparoscopic radical resection of rectal cancer has a definite sedative and analgesic effect, can effectively reduce stress response, and does not affect the recovery of gastrointestinal function of the body, which is safe and effective.
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