低剂量舒芬太尼的多模式镇痛在老年直肠癌患者术后镇痛的应用研究

徐秋妹 张燕

【摘要】 目的：探討低剂量舒芬太尼的多模式镇痛在老年直肠癌患者术后镇痛的应用效果。方法：选取2018年7月-2020年6月本院收治的老年直肠癌患者90例，按照随机数字表法将其分为对照组（n=45）和观察组（n=45）。两组均行腹腔镜直肠癌根治术治疗并给予术后多模式镇痛。术后，对照组给予舒芬太尼2 μg/kg+右美托咪定1.5 μg/kg镇痛泵镇痛，观察组给予舒芬太尼1 μg/kg+右美托咪定1.5 μg/kg镇痛泵镇痛。比较两组术后2 h（T1）、术后4 h（T2）、术后8 h（T3）、术后12 h（T4）、术后24 h（T5）、术后48 h（T6）的疼痛视觉模拟量表（VAS）评分与Ramsay镇静评分;采用舒适度评分量表（Bruggrmann comfort scale，BCS）在术后48 h评估并比较两组舒适度状态;比较两组术后不良反应发生情况及住院时间。结果：两组各时间点VAS评分比较，差异均无统计学意义（P>0.05）;观察组T2、T3时Ramsay镇静评分均低于对照组（P<0.05），其余时间点两组Ramsay镇静评分比较，差异均无统计学意义（P>0.05）。两组术后48 h舒适度比较，差异无统计学意义（P>0.05）。观察组术后不良反应发生率为6.7%低于对照组的22.2%（P<0.05）;观察组住院时间短于对照组（P<0.05）。结论：低剂量舒芬太尼的多模式镇痛具有良好的镇痛效果，同时可有效降低老年直肠癌患者术后不良反应的发生，促进患者快速康复。

【关键词】 低剂量 舒芬太尼 直肠癌 老年 多模式镇痛

Application of Multimodal Analgesia with Low-dose Sufentanil in Postoperative Analgesia in Elderly Patients with Rectal Cancer/XU Qiumei， ZHANG Yan. //Medical Innovation of China， 2021， 18（31）： -138

[Abstract] Objective： To explore the application of multimodal analgesia with low-dose Sufentanil in postoperative analgesia in elderly patients with rectal cancer. Method： A total of 90 elderly patients with rectal cancer admitted to our hospital from July 2018 to June 2020 were selected. They were divided into control group （n=45） and observation group （n=45） according to random number table method. Both groups received laparoscopic radical resection of rectal cancer and postoperative multimodal analgesia. After surgery， the control group was given Sufentanil 2 μg/kg+Dexmedetomidine 1.5 μg/kg analgesic pump for analgesia， and the observation group was given Sufentanil 1 μg/kg+Dexmedetomidine 1.5 μg/kg analgesic pump for analgesia. The pain visual analogue scale （VAS） score and Ramsay sedation score were compared between the two groups at 2 h （T1）， 4 h （T2）， 8 h （T3）， 12 h （T4），

24 h （T5） and 48 h （T6） postoperatively. Bruggrmann comfort scale （BCS） was used to evaluate and compare the comfort states of the two groups 48 h after surgery. The incidence of postoperative adverse reactions and hospital stay were compared between the two groups. Result： There were no statistical significances in VAS scores at each time point between the two groups （P>0.05）. Ramsay sedation scores at T2 and T3 in the observation group were lower than those in the control group （P<0.05）， while there were no statistically significant differences in Ramsay sedation scores at other time points between the two groups （P>0.05）. There was no significant difference in comfort states between the two groups at 48 h after surgery （P>0.05）. The incidence of postoperative adverse reactions in the observation group was 6.7%， which was lower than 22.2% in the control group （P<0.05）. The hospitalization time of observation group was shorter than that of control group （P<0.05）. Conclusion： Low-dose Sufentanil has good analgesic effect. At the same time， it can effectively reduce the incidence of adverse reactions in elderly patients with rectal cancer， and promote the recovery of patients.

[Key words] Low-dose Sufentanil Rectal cancer Elderly Multimodal analgesia

First-author’s address： Guangdong Maoming People’s Hospital， Maoming 525000， China

doi：10.3969/j.issn.1674-4985.2021.31.032

直腸癌是消化道常见的恶性肿瘤之一，在全球范围内有着较高的发病率和死亡率，给患者生活质量、家庭环境、生命安全带来极严重的威胁[1-2]。需要指出的是，直肠癌在发病早期有一定的隐匿性，大部分患者在就诊时该疾病已处于中晚期，需要采取相应的手术治疗，改善患者预后，延长生存期。……