The Impacts Of Dexmedetomidine On Postoperative Pain In Patients With Liver Cancer Receiving Patient-controlled Fentanyl

Objective To investigates the effects of dexmedetomidine on theconsumption amount of fentanly patient-controlled analgesiaand its analgesic effect on liver cancer patients who receivedhepatectomy.Methods60ASA Ⅰ or Ⅱ patients underwent partial hepaticresection at the First Affiliated Hospital of Guangxi MedicalUniversity during August2013to February2014.The patient Theselection criteria include:aged18to65, all genders, weight45to80Kg,the Child score in Class A.All of the patients aredivided into two groups by the random number table, groupD(dexmedetomidine group) and group R(control group) with30cases each.The patients of group D received dexmedetomidine0.6μg/kg[Standard weight：Standard weight=(height cm-100) x0.9(kg)] diluted by20ml normal saline,at the close the peritonealtime slowing pump injection20min, by contrast,R groups weregiven the same amount of normal saline. Slowly push fentanylinjection4μg/kg[Standard weight： Standard weight=(height cm-100) x0.9(kg)]at the sew skin time as loading dose. Connecta patient-controlled infusion analgesia (PCIA) when went toPACU.(The formula of PCIA: fentanyl1mg, tropisetron10mg,diluted into150ml with normal saline. The speed of fentanylbackground infusion2ml/h, PCA3ml/h, lock out time15mins.)Breathing recovery time(from stop pumping anesthicsto breathing recovery time),eye-opening time (from stopinganestheics to eye-opening time)and extubation time(fromstoping anesthetics to extubation) were recorded, the amountof fentaly and the times of total compressions and effectivelypressing of PCA in the postoperative24h and48h were recorded；the24h and48h VAS score were record, record the adversereaction.Result:1. There is no statistical significance difference inpostoperative respiratory recovery time and extubation timebetween team D and team R.（P>0.05）2. The consumption of Fentanyl self-control analgesia pumpdrugs and the number of press in team D is obviously less thanteam R.（P<0.05）3.There are no significicant statistical difference inpostoperative24h and48h VAS scores.(p>0.05) 4. There were less adverse reactions in team D than in team R24hours and48hours after operation.(P<0.05)Conclusion: Pump inject dexmedetomidine0.6μg/Kg [Standardweight：Standard weight=(height cm-100) x0.9(kg)]slowly20minuts before the end of operation can effectively reduce theamount of fentanly patient-controlled analgesia and pressnumbers after operation while reduce negative reaction such asvomiting and itching, it is a safe and effective postoperativesoomthing medicine.