Evaluation Of Dexmedetomidine In Combination With Sufentanil Or Butorphanol For Postoperative Analgesia In Patients Undergoing Laparoscopic Resection Of Gastrointestinal Tumors

Objective:To observe and compare the effects of different doses of dexmedetomidine combined with sufentanil or butorphanol on postoperative analgesia in patients undergoing laparoscopic resection of gastrointestinal tumor.Metheds:Eighty patients（ASA gradeⅠorⅡdegree,age 40 to 65 years）undergoing laparoscopic resection of gastrointestinal tumor were randomly assigned into four groups（n=20）,Patientcontrolled intravenous analgesia（PCIA）pump was applied at the end of surgery.Group S₁ and group S₂ separately received 1.5 ug/kg or 2.0 ug/kg dexmedetomidine combined with 2.0 ug/kg sufentanil;group N₁ and group N₂separately received 1.5 ug/kg or 2.0 ug/kg dexmedetomidine combined with 0.15mg/kg butorphanol.Pulse oxygen（SpO2）,mean blood pressure（MAP）and heart rate（HR）were observed and recorded when the patient entered the operating room（T₀）.At the point of extubation immediate（T₁）,4 hour（T₂）,8 hour（T₃）,12hour（T₄）,24 hour（T₅）and 48 hour（T₆）after extubation,the VAS and Ramsay score,SpO₂,MAP and HR were estimated.The number of patientcontrolled press of the pump,additionally analgesic remedies and the incidence of side effects were calculated,the recovery of bowel function was evaluated in terms of the first time to fart.The degree of satisfaction was also recorded when the analgesic was used up.Results:Hemodynamic changes:compared with T₀,MAP in four groups were all elevated at T₁ and declined after T₂;however,there was no significant difference between MAP at T₀ and T₁（P>0.05）;the MAP of S₂ and N₂ groups were declined significantly at T₄-T₆（P<0.05）;HR in S₂ group was decreased significantly at T₁-T₅（P<0.05）,HR in the other three groups were significantly decreased at T₁（P<0.05）.Compared with group S₁,MAP of group S₂ was significantly lower at T₄-T₆（P<0.05）;Compared with group N₂,MAP of group N₁ was elevated significantly at T₄-T₅（P<0.05）.The score of VAS in group S₂ was significantly lower than group S₁ at T₂（P<0.05）and group N₂ at T₁-T₂（P<0.05）.The postoperative anus exhaust time in group S₂ was less than in groups S₁ and N₂（P<0.05）.Group S₂ has the lowest incidence rate of nausea and vomiting,and the highest degree of satisfaction.Conclusion:Both 1.5 ug/kg and 2.0 ug/kg dexmedetomidine combined with sufentanil or butorphanol for laparoscopic gastrointestinal tumor resection on postoperative analgesia vital signs were stable,sedative and analgesic effect were perfect and less adverse reaction.Among them,2.0 ug/kg dexmedetomidine combined with sufentanil could have the best effects.It will be more suitable to be applied on laparoscopic gastrointestinal tumor resection in patients with postoperative analgesia.