The Application Of Dexmedetomidine In Postoperative Analgesia For Elderly After Transure-Thral Resection Of Prostate

Objective: In recent years,Benign prostatic hyperplasia(BPH)is one of urology clinical common disease,frequently-occurring in elderly men over the age of 50.Transure—thral Resection of Prostate because of the small blow and less pain,and the advantages of rapid recovery,has replaced the traditional open surgery,become a main method for the treatment of BPH.Due to illness in the elderly,and the changeful social environment and other factors in perioperative,it is easy to produce the negative emotions,such as tension,anxiety and depression,and lead to the higher pain threshold,which increase the postoperative complications and affects the prognosis.This requires a good postoperative pain management.This study compared Flurbiprofen axetil and Dexmedetomidine used for the safety of postoperative analgesia,adverse reactions and quality of analgesia.Method: This study is a retrospective study.Sixty patients,age 65-81 year,ASA I or II,form Jun 2015 to Jan 2016,were chosen from Yan’an Affiliated Hospital,requiring Transure—thral Resection of Prostate.And separated them into 2 groups randomly.Postoperative analgesia was completed by using dexmedetomidine combined with Flurbiprofen axetil(group A,n=30)or Flurbiprofen axetil(group B,n=30).Patients in two groups used 0.75% bupivacaine for intraspinal anesthesia,anesthesia plane was under T10.Group A was given dexmedetomidine 0.1 ug/kg/h + Flurbiprofen axetil 300 mg + tropisetron 10 mg,configuration of 100 ml;Group B was given Flurbiprofen axetil 300 mg + tropisetron 100 mg,configuration of 100 ml,setting of postoperative analgesia pump with 2 ml/h rate,and 2 ml/times,and locking time of 15 min.Observation indexes: Two groups of patients’ age,height,body weight,visual analog scale(VAS)score,Ramsaysedation scores in preoperative(T0),postoperative 2 hours(T1),postoperative 4 hours(T2),postoperative 8 hours(T3),postoperative 12 hours(T4),postoperative 24 hours(T5),postoperative 48 hours(T6)and the first time analgesia,and extra postoperative analgesia pump was observed.Recording the postoperative complications,nausea and vomiting,postoperative shivering and respiratory depression,and patient satisfaction and satisfaction with care.Secondary indicators:patient’s heart rate(HR),mean arterial pressure(MAP),systolic blood pressure(SBP),diastolic blood pressure(DBP),pulse oxygen saturation(Sp02)and operation time for each point of the time.Result: Postoperativeuseofdexmedetomidineuse wasassociated withastatisticallysignificantdropinpainscores.The postoperative VAS score in group A lower than group B,the first time press the analgesia pump in group A obviously prolonged(P< 0.05);The postoperative Ramsay score differences between the groups was statistically significant(P < 0.05),group A was higher than group B.Postoperative nausea and vomiting,postoperative shivering in two groups are compared,group A is lower than group B(P < 0.05).Group A come with a more stable hemodynamic profile than group B(P < 0.05).The postoperative nursing satisfaction score in group A is higher than that of group B(P < 0.05).Conclusion: Dexmedetomidine can be effectively used in postoperative analgesia for elderly after Transure—thral Resection of Prostate,and the incidence of complications are reduced,and postoperative nursing satisfaction is higher.