Clinical Application of Dexmedetomidine Combined with Dezocine for Patient-controlled Intravenous Analgesia in Patients after Abdominal Tumor Radical Surgery_West China Medical Journal

Authors：

 WANGXin-yuan ,  GANJian-hui , HUWan-ning , GAOHui-jun , LIUHao-ran

Department of Anesthesiology, the Affiliated Tangshan People's Hospital of Hebei Union University, Tangshan, Hebei 063000, P. R. China;

Corresponding?author：

GANJian-hui, Email: gjh71@163.com

Keywords：

Dexmedetomidine; Dezocine; Sufentanil; Patient-controlled intravenous analgesia

DOI：

10.7507/1002-0179.20150192

Video：

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Objective To evaluate the efficacy and safety of dexmedetomidine combined with dezocine for patient-controlled intravenous analgesia (PCIA) in patients after radical operation for abdominal tumor. Methods Between September 2012 and May 2013, 60 patients (aged 40-60, American Sociaty of Anesthesiologists physical statusⅠ-Ⅱ) undergoing abdominal tumor surgery and asking for PCIA pumps voluntarily were randomly divided into two groups (group D and group DF) with 30 in each group. Patients in group D were given sufentanil 0.25 μg/kg+ dezocine 0.4 mg/kg, which were added into 100 mL 0.9% normal saline, while in group DF, the patients received dexmedetomidine 1.5 μg/kg+ sufentanil 0.15 μg/kg+ dezocine 0.4 mg/kg, which were added into 100 mL 0.9% normal saline. The changes of mean arterial pressure (MAP), heart rate (HR), respiratory rate (RR), the visual analog scale (VAS), Ramsay sedation scale, Bruggrmann analgesia scale (BCS), the efficacy of postoperative analgesia and adverse effects were observed and recorded at the preoperative time (T₀), and 2 (T₁), 4 (T₂), 8 (T₃), 24 (T₄) and 48 hours (T₅) postoperatively. Results Hemodynamics in group DF was more stable than that in group D (P<0.05). There were no statically significant differences in terms of VAS and BCS between the two groups at each time point (P>0.05). The Ramsay sedation scale of group DF was better than group D, and the difference was statistically significant (P<0.05). The efficient number of pressing within 48 hours in the two groups was not significantly different (P>0.05). The incidence of nausea, vomiting and drowsiness in group D was more than that of group DF (P<0.05). Conclusion Dexmedetomidine combined with dezocine can provide effective postoperative analgesia with less adverse effects for patients after radical surgery of abdominal tumor, which provides higher satisfaction to the abdominal surgery patients.

Citation： WANGXin-yuan, GANJian-hui, HUWan-ning, GAOHui-jun, LIUHao-ran. Clinical Application of Dexmedetomidine Combined with Dezocine for Patient-controlled Intravenous Analgesia in Patients after Abdominal Tumor Radical Surgery. West China Medical Journal, 2015, 30(4): 669-672. doi: 10.7507/1002-0179.20150192 Copy

1.	方永珍, 丘小青. 靜脈與硬膜外泵注芬太尼患者自控鎮痛的臨床應用[J]. 海南醫學院學報, 2009, 15(9):1154-1156, 1159.
2.	Tan JA, Ho KM. Use of dexmedetomidine as a sedative and analgesic agent in critically ill adult patients:a meta-analysis[J]. Intensive Care Med, 2010, 36(6):926-939.
3.	郭小花, 佘守章, 宋興榮, 等. 地佐辛用于經腹全子宮切除術后自控靜脈鎮痛的量效關系[J]. 廣東醫學, 2012, 33(20):3092-3094.
4.	王純輝, 沈啟英, 李珺, 等. 地佐辛聯合舒芬太尼用于術后靜脈鎮痛的效果觀察[J]. 安徽醫科大學學報, 2012, 47(8):1003-1004.
5.	Wang ZY, Wang CQ, Yang JJ, et al. Which has the least immunity depression during postoperative analgesia:morphine, tramadol, or tramadol with lornoxicam?[J]. Clin Chim Acta, 2006, 369(1):40-45.
6.	葉鐵虎, 李大魁. 麻醉藥理學基礎與臨床[M]. 北京:人民衛生出版社, 2011:210-211.
7.	韓雪萍, 黃運里, 孫振濤, 等. 地佐辛和芬太尼用于甲狀腺術后鎮痛對患者呼吸的影響[J]. 臨床麻醉學雜志, 2011, 27(10):993-994.
8.	中華醫學會麻醉學分會. 成人術后鎮痛處理專家共識[J]. 臨床麻醉學雜志, 2010, 26(3):190-196.
9.	成毅, 于瑞文. 地佐辛復合芬太尼在術后靜脈鎮痛中的臨床觀察[J]. 中國醫藥, 2011, 6(5):587-588.
10.	岳修勤. 地佐辛與芬太尼應用于術后靜脈鎮痛的臨床效果比較[J]. 中國疼痛醫學雜志, 2010, 16(4):255.
11.	Afonso J, Reis F. Dexmedetomidine:current role in anesthesia and intensive care[J]. Rev Bras Anestesiol, 2012, 62(1):118-133.
12.	馬思杰, 張清. 右美托咪啶對術后阿片類需求的影響研究[J]. 現代中西醫結合雜志, 2012, 21(29):3256-3258.
13.	Carollo DS, Nossaman BD, Ramadhyani U. Dexmedetomidine:a review of clinical applications[J]. Curr Opin Anaesthesiol, 2008, 21(4):457-461.
14.	Yildiz M, Tavlan A, Tuncer S, et al. Effect of dexmedetomidine on haemodynamic responses to laryngoscopy and intubation:perioperative haemodynamics and anaesthetic requirements[J]. Drugs R D, 2006, 7(1):43-52.
15.	Lin TF, Yeh YC, Lin FS, et al. Effect of combining dexmedetomidinc and morphine for intravenous patient-controlled analgesia[J]. Br J Anaesth, 2009, 102(1):117-122.
16.	甘建輝, 史金麟, 胡萬寧, 等. 右美托咪定在乳腺癌前哨淋巴結活檢術中的臨床應用[J]. 中國藥房, 2013, 24(10):921-922.
17.	李志鵬, 柳垂亮. 右美托咪定的臨床應用進展[J]. 實用醫學雜志, 2013, 29(19):3254-3256.
18.	Ingersoll-Weng E, Manecke GR, Thistlethwaite PA. Dexmedetomine and cardiac arrest[J]. Anesthesiology, 2004, 100(3):738-739.

1. 方永珍, 丘小青. 靜脈與硬膜外泵注芬太尼患者自控鎮痛的臨床應用[J]. 海南醫學院學報, 2009, 15(9):1154-1156, 1159.
2. Tan JA, Ho KM. Use of dexmedetomidine as a sedative and analgesic agent in critically ill adult patients:a meta-analysis[J]. Intensive Care Med, 2010, 36(6):926-939.
3. 郭小花, 佘守章, 宋興榮, 等. 地佐辛用于經腹全子宮切除術后自控靜脈鎮痛的量效關系[J]. 廣東醫學, 2012, 33(20):3092-3094.
4. 王純輝, 沈啟英, 李珺, 等. 地佐辛聯合舒芬太尼用于術后靜脈鎮痛的效果觀察[J]. 安徽醫科大學學報, 2012, 47(8):1003-1004.
5. Wang ZY, Wang CQ, Yang JJ, et al. Which has the least immunity depression during postoperative analgesia:morphine, tramadol, or tramadol with lornoxicam?[J]. Clin Chim Acta, 2006, 369(1):40-45.
6. 葉鐵虎, 李大魁. 麻醉藥理學基礎與臨床[M]. 北京:人民衛生出版社, 2011:210-211.
7. 韓雪萍, 黃運里, 孫振濤, 等. 地佐辛和芬太尼用于甲狀腺術后鎮痛對患者呼吸的影響[J]. 臨床麻醉學雜志, 2011, 27(10):993-994.
8. 中華醫學會麻醉學分會. 成人術后鎮痛處理專家共識[J]. 臨床麻醉學雜志, 2010, 26(3):190-196.
9. 成毅, 于瑞文. 地佐辛復合芬太尼在術后靜脈鎮痛中的臨床觀察[J]. 中國醫藥, 2011, 6(5):587-588.
10. 岳修勤. 地佐辛與芬太尼應用于術后靜脈鎮痛的臨床效果比較[J]. 中國疼痛醫學雜志, 2010, 16(4):255.
11. Afonso J, Reis F. Dexmedetomidine:current role in anesthesia and intensive care[J]. Rev Bras Anestesiol, 2012, 62(1):118-133.
12. 馬思杰, 張清. 右美托咪啶對術后阿片類需求的影響研究[J]. 現代中西醫結合雜志, 2012, 21(29):3256-3258.
13. Carollo DS, Nossaman BD, Ramadhyani U. Dexmedetomidine:a review of clinical applications[J]. Curr Opin Anaesthesiol, 2008, 21(4):457-461.
14. Yildiz M, Tavlan A, Tuncer S, et al. Effect of dexmedetomidine on haemodynamic responses to laryngoscopy and intubation:perioperative haemodynamics and anaesthetic requirements[J]. Drugs R D, 2006, 7(1):43-52.
15. Lin TF, Yeh YC, Lin FS, et al. Effect of combining dexmedetomidinc and morphine for intravenous patient-controlled analgesia[J]. Br J Anaesth, 2009, 102(1):117-122.
16. 甘建輝, 史金麟, 胡萬寧, 等. 右美托咪定在乳腺癌前哨淋巴結活檢術中的臨床應用[J]. 中國藥房, 2013, 24(10):921-922.
17. 李志鵬, 柳垂亮. 右美托咪定的臨床應用進展[J]. 實用醫學雜志, 2013, 29(19):3254-3256.
18. Ingersoll-Weng E, Manecke GR, Thistlethwaite PA. Dexmedetomine and cardiac arrest[J]. Anesthesiology, 2004, 100(3):738-739.

West China Medical Journal

Clinical Application of Dexmedetomidine Combined with Dezocine for Patient-controlled Intravenous Analgesia in Patients after Abdominal Tumor Radical Surgery

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