右美托咪定复合布托啡诺对食管癌根治术患者术后镇痛的效果及氧化应激反应的影响

doi:10.3969/j.issn.1671-7171.2024.10.014

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摘要【目的】探讨右美托咪定(Dex)复合布托啡诺对食管癌根治术患者术后镇痛的效果及氧化应激反应的影响。【方法】102例食管癌根治术患者,随机分为对照组和观察组,每组51例。对照组泵注布托啡诺复合舒芬太尼进行术后镇痛,观察组泵注布托啡诺复合 Dex进行术后镇痛。比较两组苏醒情况,麻醉前后血流动力学指标[心率、平均动脉压(MAP)]、应激反应指标[肾上腺素(Adr)、皮质醇(Cor)]水平,疼痛及不良反应发生情况。【结果】观察组术后苏醒时间、术后恢复室滞留时间均短于对照组(P<0.05)。两组麻醉操作后6 min(T₁)、手术结束后2 min(T₂)时的心率、MAP水平均较麻醉前(T₀)时升高(P<0.05),T₂时的心率、MAP水平均较T₁时降低(P<0.05),且观察组T₁、T₂时的心率、MAP水平均低于对照组(P<0.05)。两组术后24 h、36 h的Adr、Cor水平均较术前升高(P<0.05),且术后36 h的Adr、Cor水平均较术后24 h降低(P<0.05);观察组术后24 h、36 h的Adr、Cor水平均低于对照组(P<0.05)。两组术后3 h、9 h、24 h、36 h的视觉模拟评分法(VAS)评分均较术前升高(P<0.05),且呈先升高后降低的趋势,观察组术后各时段VAS评分均低于对照组(P<0.05)。两组患者不良反应总发生率比较,差异无统计学意义(P>0.05)。【结论】Dex复合布托啡诺用于食管癌根治术中,可稳定患者术后血流动力学指标,加快患者苏醒,抑制围术期应激反应,减轻术后疼痛,且安全性好。

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	李现虎
	郭聪
	王玉瑶

关键词 ：食管肿瘤/外科学, 镇痛, 疼痛,手术后/药物疗法, 右美托咪定/治疗应用, 布托啡诺/治疗应用

Abstract：【Objective】 To explore the effects of dexmedetomidine (Dex) combined with butorphanol on postoperative analgesia and oxidative stress response in patients undergoing esophagectomy.【Methods】 A total of 102 patients undergoing esophagectomy were randomly divided into a control group and an observation group, with 51 patients in each group. The control group received postoperative analgesia with butorphanol and sufentanil, while the observation group received butorphanol combined with Dex. Awakening time, hemodynamic parameters [heart rate (HR), mean arterial pressure (MAP)], stress response markers [adrenaline (Adr), cortisol (Cor)], pain levels, and adverse reactions were compared between the two groups.【Results】The awakening time and postoperative recovery room stay in the observation group were shorter than those in the control group (P<0.05). In both groups, HR and MAP at 6 minutes after anesthesia (T₁) and 2 minutes after surgery (T₂) were higher than those before anesthesia (T₀) (P<0.05), while HR and MAP at T₂ were lower than those at T₁ (P<0.05). HR and MAP at T₁ and T₂ were significantly lower in the observation group compared to the control group (P<0.05). Adr and Cor levels at 24 hours and 36 hours postoperatively were higher than preoperative levels in both groups (P<0.05), with levels at 36 hours showing lower than those at 24 hours (P<0.05). The observation group had significantly lower Adr and Cor levels at 24 hours and 36 hours postoperatively compared to the control group (P<0.05). Visual Analog Scale (VAS) scores at 3, 9, 24, and 36 hours postoperatively were higher than preoperative levels in both groups (P<0.05), showing an initial increase followed by a decrease. The VAS scores of the observation group at each time period after surgery were lower than those of the control group (P<0.05). There was no statistically significant difference in the overall incidence of adverse reactions between the two groups (P>0.05).【Conclusion】 Dex combined with butorphanol in esophagectomy stabilizes postoperative hemodynamic parameters, accelerates patient recovery, suppresses perioperative stress response, reduces postoperative pain, and demonstrates good safety.

Key words： Esophageal Neoplasms/SU Analgesia Pain, Postoperative/DT Dexmedetomidine/TU Butorphanol/TU

收稿日期: 2023-05-29

中图分类号:

R735.1

通讯作者: *E-mail:330594553@qq.com

引用本文:

李现虎, 郭聪, 王玉瑶. 右美托咪定复合布托啡诺对食管癌根治术患者术后镇痛的效果及氧化应激反应的影响[J]. 医学临床研究, 2024, 41(10): 1505-1507.
LI Xianhu, GUO Cong, WANG Yuyao. Effects of Dexmedetomidine Combined with Butorphanol on Postoperative Analgesia and Oxidative Stress Response in Patients Undergoing Esophagectomy. JOURNAL OF CLINICAL RESEARCH, 2024, 41(10): 1505-1507.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2024.10.014 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2024/V41/I10/1505

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