| 徐慧胜,徐慧,王建.右美托咪定对顽固性癌痛的镇静及镇痛效果探究[J].浙江中西医结合杂志,2018,28(7): |
| 右美托咪定对顽固性癌痛的镇静及镇痛效果探究 |
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| 投稿时间：2017-09-26 修订日期：2018-05-22 |
| DOI： |
| 中文关键词: 【关键词】 右美托咪定 吗啡 静脉自控镇痛 晚期癌痛 |
| 英文关键词:【Key words】 Dexmedetomidine morphine patient-controlled intravenous analgesia refractory cancer pain |
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| 中文摘要: |
| 【】 目的 探讨右美托咪定对顽固性癌痛的镇静及镇痛效果。方法 研究对象为2015年12月~2017年2月我院收治的60例顽固性癌痛患者,并按随机数字表将患者平均分为M组和DM组。M组采用吗啡静脉自控镇痛；DM组在M组的基础上加用小剂量右美托咪定,比较两组镇痛效果、镇静效果、吗啡用量、不良反应情况以及治疗前后患者的睡眠质量情况。结果 两组给药后2、4、24、48h、10d NRS评分组间无明显差异(P>0.05)。DM组给药后2、4、24、48h、10d Ramsay镇静评分较M组同时点均有显著上升(P<0.01)。DM组用药期间30min内入睡占比为86.67%,显著高于M组(P<0.01)；DM组觉醒1次占比16.67%,显著低于M组(P<0.01)；DM组用药期间平均每日爆发痛次数、10天吗啡用量均显著低于M组(P<0.01)。DM组患者治疗后睡眠障碍发生率显著低于M组(P<0.05)。DM组恶心呕吐、便秘发生率显著低于M组(P<0.05),低血压发生率显著高于M组(P<0.05)；两组嗜睡、尿潴留、低血压发生率比较无显著差异(P>0.05)。结论 右美托咪定可减少顽固性癌痛吗啡用量,增强镇静镇痛效果,减少由吗啡引起的恶心呕吐、便秘等不良反应,提高患者的睡眠质量。 |
| 英文摘要: |
| 【Abstract】 Objective To investigate the effect of dexmedetomidine on sedation and analgesia in the trearment of patients with refractory cancer pain. Methods: The 60 cases of patients with refractory cancer pain were selected in our hospital from December 2015 to February 2017. They were randomly divided into two groups: M group and DM group. The M group was treated with morphine for patient-controlled intravenous analgesia, while the patients of DM group received a small dose of dexmedetomidine on the basis of M group. The analgesic effects, sedation effects, morphine dosage, adverse reactions as well as patient’s sleep quality before and after treatment were compared between the two groups. Results The NRS scores of two groups had no significant difference at 2, 4, 24, 48h, 10d after medication (P>0.05). The Ramsay sedation scores of the DM group 2, 4, 24, 48h, 10d after medication increased remarkably as compared with those of the M group at the identical time points (P<0.01). The proportion of medication producing sleep of the DM group was 86.67%, which was higher than those of the M group (P<0.01). And the proportion of waking up 1 time of the DM group was 16.67%, much lower than those of the M group (P<0.01). During medication the daily outbreaks of pain and 10 days'' dosage of morphine in the DM group were significantly less than those in the M group (P<0.01). The incidence of sleep disorders of DM group was significantly lower than those of M group after treatment (P<0.05). The incidences of nausea & vomiting and astriction in the DM group were lower than those in the M group (P<0.05). And the incidences of bradycardia in the DM group were higher than that in the M group (P<0.05). There was no big difference in incidence of drowsiness, uroschesis and hypotension between the two groups (P>0.05). Conclusion Dexmedetomidine could reduce the dosage of morphine for patients with refractory cancer pain, enhancing sedative and analgesic effect, reducing the rate of nausea, vomiting, constipation caused by morphine, and improving the quality of sleep. |
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