右旋美托咪啶在甲状腺切除术后自控镇痛中的应用

目的探讨右旋美托咪啶在甲状腺切除术后自控镇痛中的安全性与效能。方法选择60例行甲状腺切除术患者按随机数字表法分为2组：右旋美托咪啶组（D组）和芬太尼组（F组）,每组30例。观察D、F组患者术前,术后1、3、6、12、24、364、8 h的SBP、DBP、心率（HR）、呼吸频率（RR）、动脉血氧饱和度（SpO2）的变化。记录D、F组患者术后各时间点的VAS评分及镇静评分及术后镇痛期间患者自控镇痛（PCA）按键次数和不良反应。结果 D、F 2组患者术前,术后1、3、6、12、24、36、48 h的SBP、DBP、RR、SpO2值比较,差异无统计学意义（P〉0.05）。D组患者术后各时间点HR值较术前及F组明显降低（P〈0.05）。F组患者术后各时间点VAS评分、镇静评分值与D组比较,差异无统计学意义（P〉0.05）。D组术后镇痛期间心动过缓发生率较F组高（P〈0.01）。结论右旋美托咪啶可安全、有效地应用于甲状腺切除术后自控镇痛。

Use of Dexmedetomidine for Patient-Controlled Analgesia after Thyroidectomy

Objective To evaluate the safety and efficiency of dexmedetomidine（Dex）for patient-controlled analgesia（PCA） after thyroidectomy.Methods Sixty patients undergoing thyroidectomy were randomly divided into two groups： fentanyl group（group F） and Dex group（group D）,with 30 patients in each group.Systolic blood pressure（SBP）,diastolic blood pressure（DBP）,heart rate（HR）,respiratory rate（RR） and hemoglobin oxygen saturation（SpO2） were recorded before and 1,3,6,12,24,36 and 48 hours after operation.The VAS scores and sedation scores were estimated at different postoperative time points,and PCA pressing frequency and adverse effects were examined.Results There were no significant differences in SBP,DBP,RR and SpO2 between group D and group F before and after thyroidectomy（P0.05）.In group D,postoperative HR was lower than preoperatively（P0.05）.Compared with group D,postoperative HR increased and the incidence of bradycardia during analgesia decreased in group F（P0.05）.There were no differences in VAS scores and sedation scores between the two groups（P0.05）.Conclusion Dex is safe and effective for PCA after thyroidectomy.