摘要
目的探讨舒芬太尼复合小剂量艾司氯胺酮静脉自控镇痛在宫颈癌术后患者中的应用效果。方法选取山东大学第三人民医院2021年8月至2022年8月收治的80例行经腹全子宫切除术的宫颈癌患者作为研究对象,按照随机数字表法分为观察组与对照组,每组各40例。对照组采用舒芬太尼进行术后镇痛,观察组采用舒芬太尼复合小剂量艾司氯胺酮进行术后镇痛,比较两组镇痛药物使用情况、镇痛效果、术后血流动力学水平、疼痛应激情况及不良反应发生情况。结果观察组镇痛泵按压次数、舒芬太尼用量均少于对照组,差异有统计学意义(P<0.05)。观察组术后4 h(T1)、8 h(T2)、12 h(T3)、24 h(T4)、48 h(T5)的视觉模拟评分法评分均低于对照组,差异有统计学意义(P<0.05)。两组Ramsay镇静评分比较,差异无统计学意义(P>0.05)。观察组T2、T3、T4、T5的平均动脉压、心率均低于对照组,差异有统计学意义(P<0.05)。观察组T3、T5的促肾上腺皮质激素、皮质醇水平均低于对照组,差异有统计学意义(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论舒芬太尼复合小剂量艾司氯胺酮静脉自控镇痛在宫颈癌术后患者中的应用效果显著,可减少舒芬太尼用量,减轻疼痛,稳定术后血流动力学水平,且不增加不良反应。
Objective To explore the application effect of Sufentanil combined with low-dose Esketamine intravenous patient-controlled analgesia in postoperative patients with cervical cancer.Methods A total of 80 patients with cervical cancer undergoing transabdominal total laparohysterectomy admitted to Jinan Third People’s Hospital from August 2021 to August 2022 were selected as the study objects.All the patients were divided into the observation group and the control group by the random number table method,with 40 cases in each group.The control group received Sufentanil for postoperative analgesia,and the observation group received Sufentanil combined with low-dose Esketamine for postoperative analgesia.The use of analgesic drugs,analgesic effects,levels of postoperative hemodynamic,incidence of pain stress,and adverse reactions in the two groups were compared.Results The times of analgesic pump press and the dosage of Sufentanil in the observation group were less than those in the control group,and the differences were statistically significant(P<0.05).The scores of visual analogue scale at 4 hours(T1),8 hours(T2),12 hours(T3),24 hours(T4),and 48 hours(T5)after surgery in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in Ramsay sedation score between the two groups(P>0.05).The mean arterial pressure and heart rate at T2,T3,T4,and T5 in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The levels of adrenocorticotropic hormone and cortisol at T3 and T5 in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion The application effect of Sufentanil combined with low-dose Esketamine intravenous patient-controlled analgesia in postoperative patients with cervical cancer is significant,which can reduce the dosage of Sufentanil,relieve pain,and stabilize the levels of postoperative hemodynamic,and does not increase adverse reactions.
作者
任金玉
REN Jinyu(Department of Anesthesiology,Jinan Third People’s Hospital,Shandong Province,Jinan 250132,China)
出处
《妇儿健康导刊》
2024年第11期79-83,共5页
JOURNAL OF WOMEN AND CHILDREN'S HEALTH GUIDE
关键词
舒芬太尼
艾司氯胺酮
经腹全子宫切除术
宫颈癌
Sufentanil
Esketamine
Transabdominal total laparohysterectomy
Cervical cancer
