舒芬太尼和右美托咪定对胃癌术后镇痛效果对比及对术后快速康复的影响

目的:探讨舒芬太尼和右美托咪定对胃癌术后镇痛效果对比及对术后快速康复的影响。方法:选取我院2017年6月到2019年12月共收治的200例胃癌患者进行对比研究,所有患者在行胃癌根治术后均要求进行术后镇痛,依照随机分组法将患者分为A组(n=67)、B组(n=66)和C组(n=67),A组患者给予2μg/kg舒芬太尼,B组患者给予2μg/k舒芬太尼联合1μg/kg右美托咪定,C组患者给予2μg/k舒芬太尼联合2μg/kg右美托咪定。对比三组患者术后不同时间的疼痛程度、炎性因子水平、术后恢复情况与不良反应情况。结果:三组患者术后2 h、术后6 h、术后12 h、术后24 h的视觉模拟评分法(Visual analog scales,VAS)评分对比发现,通过时间的增加,三组患者的VAS评分均逐渐降低(P<0.05),且三组患者在相同时间点的VAS评分差异显著(P<0.05),且C组数值最小;三组患者术前肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、白细胞介素-6(Interleukin-6,IL-6)、IL-10对比无显著差异(P>0.05),在术后1 d TNF-α、IL-6数值增加,C组的数值最小(P<0.05),而三组患者的IL-10明显降低,且C组数值最大(P<0.05);三组患者的进食时间、下床活动时间、肠胃功能恢复时间和住院时间对比差异显著,且C组患者的时间最短(P<0.05);三组患者的不良反应发生情况对比无显著差异(P>0.05)。结论:对胃癌术后患者应用舒芬太尼和右美托咪定对患者进行镇痛处理,能够减轻患者的疼痛感,降低患者的炎症反应,利于患者术后快速康复,其中以C组的2μg/k舒芬太尼联合2μg/kg右美托咪定剂量的药物对患者术后恢复情况效果显著,且不增加不良反应,安全性好,值得临床应用推广。

Comparison of Analgesic Effect of Sufentanil and Dexmedetomidine on Postoperative Patients with Gastric Cancer

Objective: To compare the analgesic effect of sufentanil and dexmedetomidine on postoperative patients with gastric cancer and their effects on postoperative rapid recovery. Methods: A total of 200 patients with gastric cancer, who were admitted to General Hospital of the Central Theater of the Chinese People’s Liberation Army from June 2017 to December 2019, were selected. All the patients required postoperative analgesia after radical gastrectomy. The patients were randomly divided into group A(n=67), group B(n=66) and group C(n=67). Group A was given sufentanil 2 μg/kg;group B was given sufentanil 2 μg/kg combined with dexmedetomidine 1 μg/kg;group C was given sufentanil 2 μg/kg combined with dexmedetomidine 2 μg/kg. The pain degree, inflammatory factor level,postoperative recovery and adverse reactions of the three groups were compared at different time after operation. Results: After the VAS scores of three groups of patients 2 h, 6 h, 12 h and 24 h after operation were compared, the VAS scores of the three groups were found gradually decreased with the increase of time(P<0.05), and the VAS scores of the three groups at the same time point were significantly different(P<0.05), and the number of group C was the smallest. Through the comparison of the inflammatory factors levels of the three groups before operation and 1 day after operation, it was found that before the operation, there was no significant difference in TNF-α,IL-6 and IL-10(P>0.05), but TNF-α and IL-6 increased 1 day after operation, and the difference between groups was significant, and the value of group C was the smallest(P<0.05). On the first day after operation, the IL-10 of three groups decreased significantly, and the difference was gradually significant, and the value of group C was the largest(P<0.05). There were significant differences in eating time,ambulation time, gastrointestinal function recovery time and hospitalization time among the three groups, and the time of group C was the shortest(P<0.05). There was no significant difference in the incidence of adverse reactions among the three groups(P>0.05). Conclusions: The application of sufentanil and dexmedetomidine for postoperative gastric cancer patients can reduce the pain and inflammatory reaction of patients, which is good for the rapid recovery of patients after operation. Sufentanil combined with 2 μg/kg dexmedetomidine is better for the postoperative recovery of patients, and it does not increase the adverse reactions, which is worthy of clinical application and promotion.