|
Abstract: 【Abstract 】: Objective: To observe the efficacy and safety of dexmedetomidine combined with sufentanil for patients with mitral stenosis controlled intravenous analgesia after valve replacement . Methods: 40 cases of heart valve replacement surgery patients aged 45 - 70 years with American Society of Anesthesi ologists class Ⅱ～Ⅲ .All patinents were randomly assigned to, sufentanil group (SF group) and sufentanil combined with dexmedetomidine group (SD group). SF group was treated with sufentanil (0.09ug/kg/h)by patient-controlled intravenous analgesia (PCIA) and sufentanil (0.09ug/kg/h)combined with dexmedetomidine(0.08ug/kg/h) PCIA, the two groups were compared at 12h（T1）、24h（T2）、36h（T3）、48h(T4).The visual analog scale (VAS), Ramsay - score, mean radial artery pressure (MAP), finger pulse oxygen saturation (SPO2) and the rate of adverse reaction of patients after operation(respiratory depression, nausea, vomiting, etc.) . Results: (1) VAS: At T1、 T2、T3、T4, there was significant difference between SD group [(2.4±0.6)、（2.8±0.7）、（2.3±0.6）、（2.0±0.4）]and SF group [(4.0±1.0)、（4.3±1.1）、（3.7±0.7）、（3.5±0.5)] in VAS（P<0.05）．(2) Ramsay - score : At T1、 T2、T3、T4, there was significant difference between SD group[（3.3±0.5）、（3.0±0.4）、（3.5±0.6）、（ 3.2±0.7）]and SF group [(1.2±0.6)、（1.4±0.4）、（1.2±0.5）、（1.1±0.6）] in Ramsay - score（P<0.05）. (3) MAP: Compared with the MAP at T0 (82.9±11.9), the MAP at T1、 T2、T3、T4 [(98.6±10.9)、（98.9±12.1）、（95.7±13.1）、（93.1±12.9）was increased in SF group（P<0.05）. Compared with the MAP at T0 （82.1±12.9）, the MAP at T1、 T2、T3、T4 [(85.6±10.4)、（86.2±9.7 ）、（84.3±10.6）、（82.8±10.2）]was no significant difference in SD group（P>0.05）.There was no significant difference between SD group and SF group at T0（P>0.05）. At T1、 T2、T3、T4, the MAP of SD group was more stable than SF group（P<0.05）.(4) There was no significant difference between SD group and SF group at T0、 T1、 T2、T3、T4 in SPO2. (5) The rate of adverse reaction: At T1、 T2、T3、T4, the rate of nausea and vomiting in SD group [10%、5%] was obviously lower than SF goup [25%、15%]（P<0.05）. There was no respiratory inhibition in SF group and SD group. Conclusion: Sufentanil combined with dexmedetomidine to patients after valve replacement in mitral stenosis can increase the effort to sufentanil for analgesia . It provide satisfactory sedation and being low in adverse reaction.
|
