| Objective:To observe the effects of dexmedetomidine on sufentanil ED50 for patient-controlled intravenous analgesia after cesarean section.Methods:A total of 106 primiparas who underwent elective cesarean section in our hospital from October 2020 to February 2021 were selected.All parturients were randomly divided into sufentanil group(group S)and dexmedetomidine combined with sufentanil group(group DS),53 cases in each group.Group PCA drug formula:S group:sufentanil+tropisetron 5mg+normal saline 100ml;DS group:sufentanil+1.5μg/kg dexmedetomidine+tropisetron 5mg+normal saline 100ml,maintained for 48 hours.The VAS score of postoperative analgesia in two groups was less than or equal to 3 within 6h after surgery.The initial dose of sufentanil was 1.5μg/kg,which gradually increased or decreased according to the satisfactory or unsatisfactory effect.If the analgesic effect was effective,the next case was given a lower concentration,and if the analgesic effect was ineffective,the next case was given a higher concentration.The ED50 and 95%CI of sufentanil were determined by Dixon Massey method.Systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR),oxygen saturation(Sp02),VAS pain score and Ramsay were recorded before anesthesia(T0),2 h(T1),4 h(T2),6h(T3),12 h(T4),24 H(T5)and 48 h(T6)Sedation score were recorded.The total consumption of sufentanil and tramadol,lactation time,sleep status and adverse reactions were recorded.The time of the onset of lactation was recorded,and the Athens Insomnia Scale(AIS)was used to evaluate the sleep status of the women.The dosage of sufentanil and the additional amount of tramadol and the number of PCA were recorded,and the incidence of adverse reactions was recordedorded.and the incidence of adverse reactions was recorded to observe the incidence of dizziness,itching,nausea,vomiting,bradycardia and hypotension after obstetrics The satisfaction evaluation of postoperative PCIA analgesia in the two groups was recorded.Results:There was no difference in SBP,DBP,HR and SpO2 between the two groups at each time point after operation(P>0.05).The VAS scores at rest and exercise at T4-T6 in the two groups were significantly lower than those at T2.The VAS scores at T4-T5 and at rest at T5 in the group DS were significantly lower than those in the group S(P<0.05).The Ramsay score of group DS at T2-T5 was higher than that of group S(P<0.05)and there was no difference between the two groups at T6(P>0.05).The dosage of sufentanil and tramadol in group DS was significantly lower than that in group S,and the time of lactation in group DS was shorter than that in group S(P<0.05).There was no difference in the number of PCA between the two groups(P>0.05).The AIS score at T5 and T6 was significantly higher than that at T0(P<0.05),compared with group S,the AIS scores of group DS were decreased at T5 and T6(P<0.05),The AIS scores at T5 and T6 were significantly higher than those at T0(P<0.05),and compared with group S,the AIS score of group DS was lower at T5 and T6(P<0.05).Compared with group S,the incidence of nausea,vomiting and pruritus in group DS was significantly lower(P<0.05).Compared with group S,the satisfaction of PCIA analgesia in group DS was significantly increased(P<0.05).The ED50 and 95%confidence interval of PCIA sufentanil were 1.294μg/kg(1.237-1.354μg/kg)and 1.742μg/kg(1.556-1.950μg/kg),respectively.Compared with group S,ED50 of sufentanil analgesia in group DS was lower(P<0.05).Conclusion:In conclusion,combined 1.5μg/kg dexmedetomidine can significantly reduce PCIA sufentanil ED50 in women with cesarean section,and has no effect on hemodynamics after obstetrics and gynecology.The time for women to start lactation after surgery is shortened,sleep quality is improved,and the incidence of nausea,vomiting and pruritus is also reduced. |
