Effects Of Dexmedetomidine Combined With Sufentanil On Patient-controlled Intravenous Analgesia In Postthoractomy

Objective: Discuss dexmedetomidine definite joint ShuFen, the application inopen chest postoperatively in patients with lung cancer and esophageal cancer effect aradical cure the efficacy and safety of self-control vein analgesia,dexmedetomidinecannot decide whether can reduce the dose sufentanil and reduce the side effects,improve patient comfort and satisfaction.Methods:60patients underrgoing elective thoracotomy surrgery.ASA class I~Ⅱ,Age40~70,Anesthesia for general anesthesia.60patients were randnomly dividedinto sufenntanil combined right beautiful mi on analgesia group D (20)、 Epiduralanalgesia group E (20) and sufenntanil analgesia group S (20),All patientts had nopreopperative medication.Into the operating room after monitoring blood pressure,blood oxyggen saturation, ecg and bis, upper limb vennous infusion.Bureau of thelower dexmedettomidine catheter CVP, radiial or braachial artery ABP.Group Dintravenous anesthesia induction in the first10minutes dexmedettomidine1g/kg, in aclosed chest open analgesia pump, sufentanil200mu g, right beauty holds the mi200mu g with0.9%sodium chloride solution with a0.2L first dose3ml, background doseof2ml/h, PCA dose3ml/second, lock in ten minutes;T5or T64-6group E line7epidural catheter and give1%lidocaine as experiment dose,5ml detection have theanesthesia plane and exclude subarachnoid block, ten minutes before anesthesiainduction vein pump into the amount of normal saline,Closed chest open analgesiapump, sufentanil50mu g, with hydrochloric acid,0.9%sodium chloride solution of0.3g pp paid into0.2L, the first dose of4ml, background dose of4ml/h, PCA dose of4ml/second, lock for30minutes;10minutes before the group S narcotic induction veinpump into the amount of normal saline, closed chest open analgesia pump, sufentanil200mu g with0.9%sodium chloride solution with the first dose of3ml,200ml background dose of2ml/h, PCA dose3ml/second, lock for10minnutes. Observationindexes:(1) general informmation: age, gendder, weiight, heigght, ASA grade;(2)intraoperative observation indexes: into the opperating room (T1), right themicrophones on pumping after10miinutes (T2), endotrcheal inttubation (T3),immiediately after surgery (T4), at the begginning of30minnutes after the strart (T5), atthe end of surgery (T6)6point of systolic pressure, diaastolic preessure and meanartertal preessure, ventricular rate and electrical dual frequency index (bis),intraoperative flutd, blood loos, urtne ouput, and the anesthetic dosage;(3)1,4,8,16,24,48hours, by the mettod of visual analogue scale (VAS) evaluation of the deggree ofpain;(4)Sufentanil48hours the toial ammount, press the nummber of PCA;(5)1,4,8,16,24,48hours in patients with a MAP, HR, RR, SpO2;(6)48hours after Ramsayscore;(7) records of pattents with naisea and vomiiting and respiratory depression, chils,cardiovascular events, urinarry reteention, such as the occurence of advearse events.Results:(1)The improvement of the general situation of the three groups of patients,operaition time, aneasthesia time, urine, intrraoperative blood loes and rehydrationduring total comparative diffeirences were not staitisticaly signitficant.(2) three groupsof patients with postoperative1h,4h,8h,16h,24h and48h SBP, DBP, HR,hemodynamic group D group S and group E more stable.(3)1-16h after restingcompared with exercise VAS score, group D than S group signnificantly reduced,higgher than that of group E, the diffeerence had staitisticall signifficance, and16-48hthree groups have no statistical difference in meaning.(4)1-24h after three sets ofsedation scores at each time point group D was higher than S, E diifference betveen thetwo graups was sttatistica1ly signtificant, postoperative sedation score group S higherthan4to8h E group difference was statistically significant.(5)chils, vommiting, naesea,postaperative sensary distturbance compared the inccidence of complications, such aslower than S group D and E two groups, the diffarence is statistica11y signficant, allpatients have no respiratory depression.Conclusion:Dexmedetomidine joint ShuFen well applied in open heart surgerypatients with venous self-control analgesia is safe, effective, relieve pain, reduce thedosage of sufentanil and reduce the inciddence of adwerse reacttions.