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首页> 美国卫生研究院文献>International Journal of Medical Sciences >Effects of dexmedetomidine in combination with fentanyl-based intravenous patient-controlled analgesia on pain attenuation after open gastrectomy in comparison with conventional thoracic epidural and fentanyl-based intravenous patient-controlled analgesia
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Effects of dexmedetomidine in combination with fentanyl-based intravenous patient-controlled analgesia on pain attenuation after open gastrectomy in comparison with conventional thoracic epidural and fentanyl-based intravenous patient-controlled analgesia

机译：与传统的胸膜硬膜外和基于芬太尼的静脉自控镇痛相比右美托咪定联合以芬太尼为基础的静脉自控镇痛对开腹胃切除术后疼痛减轻的影响

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>Background: This study was investigated the effects of dexmedetomidine in combination with fentanyl-based intravenous patient-controlled analgesia (IV-PCA) on pain attenuation in patients undergoing open gastrectomy in comparison with conventional thoracic epidural patient-controlled analgesia (E-PCA) and IV-PCA.>Methods: One hundred seventy-one patients who planned open gastrectomy were randomly distributed into one of the 3 groups: conventional thoracic E-PCA (E-PCA group, n = 57), dexmedetomidine in combination with fentanyl-based IV-PCA (dIV-PCA group, n = 57), or fentanyl-based IV-PCA only (IV-PCA group, n = 57). The primary outcome was the postoperative pain intensity (numerical rating scale) at 3 hours after surgery, and the secondary outcomes were the number of bolus deliveries and bolus attempts, and the number of patients who required additional rescue analgesics. Mean blood pressure, heart rate, and adverse effects were evaluated as well.>Results: One hundred fifty-three patients were finally completed the study. The postoperative pain intensity was significantly lower in the dIV-PCA and E-PCA groups than in the IV-PCA group, but comparable between the dIV-PCA group and the E-PCA group. Patients in the dIV-PCA and E-PCA groups needed significantly fewer additional analgesic rescues between 6 and 24 hours after surgery, and had a significantly lower number of bolus attempts and bolus deliveries during the first 24 hours after surgery than those in the IV-PCA group.>Conclusions: Dexmedetomidine in combination with fentanyl-based IV-PCA significantly improved postoperative analgesia in patients undergoing open gastrectomy without hemodynamic instability, which was comparable to thoracic E-PCA. Furthermore, this approach could be clinically more meaningful owing to its noninvasive nature.
机译：>背景：该研究调查了右美托咪定联合以芬太尼为基础的静脉自控镇痛（IV-PCA）与常规胸膜硬膜外自控对照相比对开腹胃切除术患者疼痛减轻的影响镇痛（E-PCA）和IV-PCA。>方法：计划进行开放性胃切除术的171例患者随机分为3组：常规胸腔E-PCA（E-PCA组） ，n = 57），右美托咪定联合基于芬太尼的IV-PCA（dIV-PCA组，n = 57）或仅基于芬太尼的IV-PCA（IV-PCA组，n = 57）。主要结局是手术后3小时的术后疼痛强度（数字评分量表），次要结局是推注药量和推注次数以及需要额外急救镇痛药的患者人数。还评估了平均血压，心率和不良反应。>结果：最终完成了153例患者的研究。 dIV-PCA和E-PCA组的术后疼痛强度明显低于IV-PCA组，但在dIV-PCA组和E-PCA组之间相当。 dIV-PCA和E-PCA组的患者在手术后6到24小时之间需要的额外止痛药明显减少，并且在手术后的前24小时内推注和推注分娩的次数明显少于IV-PCA和E-PCA组。 PCA组。>结论：右美托咪定联合以芬太尼为基础的IV-PCA可以显着改善开腹胃切除术患者的术后镇痛效果，而无血流动力学不稳定性，这与胸部E-PCA相当。此外，由于其无创性，这种方法在临床上可能更有意义。

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