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[1]徐毅明,庄伟,李学艳,等.右美托咪定联合盐酸羟考酮超前镇痛对深度烧伤削痂植皮手术患者术后镇痛效果的影响[J].医学研究与战创伤救治(原医学研究生学报),2022,24(5):490-494.[doi:10.3969/j.issn.1672-271X.2022.05.009]
　XU Yi-ming,ZHUANG Wei,LI Xue-yan,et al.Effects of dexmedetomidine combined with oxycodone hydrochloride on postoperative analgesia of deep burns patients undergoing tangential excision and skin grafting[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2022,24(5):490-494.[doi:10.3969/j.issn.1672-271X.2022.05.009]
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右美托咪定联合盐酸羟考酮超前镇痛对深度烧伤削痂植皮手术患者术后镇痛效果的影响()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第24卷
期数:
2022年5期
页码:
490-494
栏目:
临床研究
出版日期:
2022-11-02

文章信息/Info

Title:
Effects of dexmedetomidine combined with oxycodone hydrochloride on postoperative analgesia of deep burns patients undergoing tangential excision and skin grafting
作者:
徐毅明; 庄伟; 李学艳; 黄晓晨; 顾成永; 汪巧玲
作者单位：215000苏州，南京医科大学附属苏州医院、苏州市立医院(北区)麻醉科（徐毅明、李学艳、黄晓晨、顾成永、汪巧玲）；528000佛山，佛山市第一人民医院麻醉科（庄伟）
Author(s):
XU Yi-ming1;  ZHUANG Wei2;  LI Xue-yan1;  HUANG Xiao-chen1;  GU Cheng-yong1;  WANG Qiao-ling1
(1.Deparment of Anesthesiology, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital,North District, Soochow 215000,Jiangsu, China; 2. Deparment of Anesthesiology, Foshan Municipal First People’s Hospital, Foshan 528000, Guangdong, China)
关键词:
右美托咪定; 盐酸羟考酮; 超前镇痛; 烧伤; 削痂植皮; 术后镇痛
Keywords:
dexmedetomidine;  oxycodone hydrochloride;  advanced analgesia;  burns;  tangential excision and skin grafting;  postoperative analgesia
分类号:
R614
DOI:
10.3969/j.issn.1672-271X.2022.05.009
文献标志码:
A
摘要:
目的探究右美托咪定联合盐酸羟考酮超前镇痛对深度烧伤削痂植皮手术患者术后镇痛效果的影响。方法选取2021年1月至2021年12月于苏州市立医院(北区)烧伤科行削痂植皮手术的深度烧伤患者80例，按照随机数字表法分为右美托咪定组（Dex组）和右美托咪定联合盐酸羟考酮（Dex-Oxy组）。在麻醉诱导前15 min，Dex组给予右美托咪定（1 μg/kg）静脉缓慢输注至手术结束；Dex-Oxy组给予右美托咪定（1 μg/kg）和盐酸羟考酮（0.1 mg/kg）静脉缓慢输注至手术结束。术后2组均行静脉自控镇痛。采用视觉模拟评分（VAS）和Ramsay评分评估患者术前、术后12 h、24 h疼痛情况及镇静水平，比较2组患者术后24 h内补救镇痛率、恶心呕吐及呼吸抑制发生率。采用酶联免疫吸附试验（ELISA）检测血清炎症因子白介素-1β（IL-1β）、白介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）；血清疼痛介质5-羟色胺（5-HT）、去甲肾上腺素（NE）。结果Dex-Oxy组患者术后12h、24 h的VAS、Ramsay评分低于Dex组（P<0.01）；Dex-Oxy组术后24 h内补救镇痛率、恶心呕吐和呼吸抑制发生率低于Dex组（P<0.05）；术前2组患者血清炎症因子（IL-1β、IL-6、TNF-α）、血清疼痛介质（5-HT、NE）水平比较差异无统计学意义（P>0.05）；术后24 h，2组患者血清IL-1β、IL-6、TNF-α水平均高于术前（P<0.01），但Dex-Oxy组[（2.39±0.69，4.54±1.01，2.68±0.86）ng/mL]低于Dex组[（3.04±0.95，6.60±1.69，3.61±1.17）ng/mL]（P<0.01）；术后24 h，2组患者血清5-HT、NE均低于术前（P<0.01），Dex-Oxy组[（0.30±0.15)μmol/L，(209.89±58.07）μg/L]低于Dex组[（0.50±0.18)μmol/L，(287.66±46.92）μg/L]（P<0.01）。结论右美托咪定联合盐酸羟考酮可有效缓解深度烧伤削痂植皮手术患者术后疼痛，减少不良反应，降低血清炎症因子及疼痛介质水平，改善患者术后恢复质量。
Abstract:
ObjectiveTo explore the effect of dexmedetomidine combined with oxycodone hydrochloride on postoperative analgesia of deep burns patients undergoing tangential excision and skin grafting.Methods80 patients with deep burns underwent angential excision and skin grafting in the Burn Department of Suzhou Municipal Hospital (North District) from January to December 2021 were selected. They were divided into two groups: dexmedetomidine group (Dex group) and dexmedetomidine combined with oxycodone hydrochloride (Dex-Oxy group). The Dex group was treated with dexmedetomidine (1 μg/kg) and Dex-oxy group with dexmedetomidine (1 μg/kg) and oxycodone hydrochloride (0.1 mg/kg) by slow intravenous infusion until the end of surgery before 15 min of anesthesia induction. Automatic intravenous analgesia pump infusion was performed in both groups after operation. Visual analogue scale (VAS) and Ramsay score were used to evaluate the pain and sedation level of two group. The remedial analgesia rate, incidence of nausea and vomiting and respiratory depression were compared between the two groups. The serum levels of interleukin-1β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), 5-hydroxytryptamine (5-HT) and norepinephrine (NE) were detected by enzyme-linked immunosorbent assay (ELISA).ResultsVAS and Ramsay scores at 12 and 24 h after surgery in Dex-Oxy group were lower than those in Dex group（P<0.01）. The rate of postoperative analgesia, nausea and vomiting, and respiratory depression within 24 hours in Dex-Oxy group was lower than that in Dex group（P<0.05）. There were no significant differences in serum inflammatory cytokines (IL-1β, IL-6, TNF-α) and serum pain mediators (5-HT, NE) between two groups before operation（P>0.05）. At 24 h after operation, the levels of serum IL-1β, IL-6 and TNF-α in two groups were higher than those before operation （P<0.01）, but Dex-Oxy group [（2.39±0.69，4.54±1.01，2.68±0.86）ng/mL] were lower than Dex group [（3.04±0.95，6.60±1.69，3.61±1.17）ng/mL]（P<0.01）. And serum 5-HT and NE in two groups were lower than those before operation（P<0.01）, Dex-Oxy group[（0.30±0.15)μmol/L，(209.89±58.07）μg/L] were lower than Dex group [（0.50±0.18)μmol/L，(287.66±46.92）μg/L]（P<0.01）.ConclusionDexmedetomidine combined with oxycodone hydrochloride can effectively relieve postoperative pain, reduce adverse reactions, inhibit the release serum inflammatory factors and pain mediators, and improve postoperative recovery quality of deep burns patients undergoing tangential excision and skin grafting.

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更新日期/Last Update: 2022-11-16