Ge Dong-Jian, Qi Bin, Tang Gang, Li Jin-Yu
From the Department of Anesthesiology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu, P.R. China (D-JG, BQ, GT, J-YL).
Medicine (Baltimore). 2015 Oct;94(43):e1727. doi: 10.1097/MD.0000000000001727.
Surgery-induced acute postoperative pain and stress response may lead to prolonged convalescence. The present study was designed to investigate the effects of intraoperative dexmedetomidine on postoperative analgesia and recovery after abdominal colectomy surgeries.Sixty-seven patients scheduled for abdominal colectomy under general anesthesia were divided into two groups, which were maintained using propofol/remifentanil/dexmedetomidine (PRD) or propofol/remifentanil/saline (PRS).During surgery, patients in the PRD group had a lower bispectral index value, which indicated a deeper anesthetic state and a higher sedation score right after extubation, than patients in the PRS group. During the first 24 hours after surgery, PRD patients consumed less morphine in patient-controlled analgesia, and had a lower score in visual analog scale, than their controls from the PRS group. The global 40-item quality of recovery questionnaire and 9-question fatigue severity score both showed a higher recovery score from day 3 after surgery in the PRD group.Intraoperative administration of dexmedetomidine seems to promote the analgesic property of morphine-based patient-controlled analgesia, and speed recovery from surgery in patients after abdominal colectomy.
手术引起的急性术后疼痛和应激反应可能导致康复期延长。本研究旨在探讨术中使用右美托咪定对腹部结肠切除术后镇痛及恢复的影响。67例计划在全身麻醉下进行腹部结肠切除术的患者被分为两组，分别使用丙泊酚/瑞芬太尼/右美托咪定（PRD）或丙泊酚/瑞芬太尼/生理盐水（PRS）进行维持麻醉。手术过程中，PRD组患者的脑电双频指数值较低，表明麻醉状态更深，拔管后镇静评分更高，高于PRS组患者。术后24小时内，PRD组患者在自控镇痛中使用的吗啡较少，视觉模拟评分较低，低于PRS组的对照组。全球40项恢复质量问卷和9项疲劳严重程度评分均显示，PRD组患者术后第3天的恢复评分更高。术中给予右美托咪定似乎可增强基于吗啡的自控镇痛的镇痛效果，并加速腹部结肠切除术后患者的手术恢复。
