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| 右美托咪定复合舒芬太尼术后镇痛对经腹子宫切除术患者睡眠质量的影响 |
| Effect of dexmedetomidine plus sufentanil administered for postoperative analgesia on sleep quality in patients undergoing abdominal hysterectomy |
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| DOI： |
| 中文关键词: 右美托咪定 术后镇痛 睡眠剥夺 多导睡眠图 |
| 英文关键词: Dexmedetomidine Postoperative analgesia Sleep disturbance Polysomnography |
| 基金项目: |
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| 摘要点击次数: 3343 |
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| 中文摘要: |
| 目的 探讨右美托咪定复合舒芬太尼术后镇痛对患者睡眠质量的影响。方法 选择择期行经腹全子宫切除术的患者60例,年龄30～55岁,ASA Ⅰ或Ⅱ级。随机分为两组:舒芬太尼组(C组)和舒芬太尼+右美托咪定组(D组),每组30例。术后给予PCIA。连续3夜［当晚21∶00至次日6∶00,术前1夜(PSG1),术后第1夜(PSG2),和术后第2夜(PSG3)］对患者进行多导联睡眠功能监测,观察指标包括各期睡眠分布[非快速动眼睡眠（N1,N2,N3）和快速动眼睡眠（REM）],睡眠觉醒指数,睡眠效率及主观睡眠质量评分。采用VAS评分评估患者术后疼痛,同时记录舒芬太尼累积消耗量、镇静评分、MAP、 HR和SpO2。结果 与PSG1时比较,PSG2和PSG3时C组N1期睡眠明显增加(P<0.05),D组N1期睡眠明显减少、N2期睡眠明显增加(P<0.05),两组N3期和REM期睡眠明显减少、睡眠效率和主观睡眠质量明显降低、觉醒指数明显升高(P<0.05)。与C组比较,PSG2和PSG3时D组N1期睡眠明显减少、N2期睡眠明显增加(P<0.05);D组睡眠效率和主观睡眠质量明显升高,觉醒指数明显降低(P<0.05)。与C组比较,术后6、24和48 h D组VAS评分明显降低、舒芬太尼累积消耗量明显减少、MAP明显降低、HR明显减慢(P<0.05),术后6、24 h D组镇静评分明显升高(P<0.05)。结论 右美托咪定复合舒芬太尼用于经腹子宫切除术后患者自控静脉镇痛,提供良好镇痛的同时改善患者睡眠剥夺,提高患者的睡眠质量。 |
| 英文摘要: |
| Objective To evaluate the effects of dexmedetomidine plus sufentanil during postoperative analgesia on sleep quality in patients undergoing abdominal hysterectomy. Methods Sixty patients (aged 30-55 years, ASA Ⅰ or Ⅱ) scheduled for hysterectomy were randomly divided into the following 2 groups: group C (n=30, sufentanil) and group D (n=30, sufentanil plus dexmedetomidine). Polysomnography measures were performed, the night before surgery (PSG1), the first night after surgery (PSG2), and the second night after surgery (PSG3). In addition, pain levels (visual analogue scale, VAS), sedation levels, sufentanil consumptions, and possible adverse effects on MAP, HR and SpO2 were investigated. Results Compared with PSG1, N1 stage sleep in group C and N2 stage sleep in group D were significantly increased (P<0.05), N1 stage sleep at PSG2 and PSG3 in group D was decreased (P<0.05); N3 and REM stage sleep, sleep efficiency index and subjective sleep quality were decreased, arousal index was increased in two groups (P<0.05). Compared with group C, N1 stage sleep was decreased, and N2 stage sleep was increased at PSG2 and PSG3 in group D (P<0.05); sleep efficiency index, subjective sleep quality were increased, arousal index in group D was decreased (P<0.05). Patients in group D had a lower VAS score and cumulative sufentanil consumption, MAP, HR at 6, 24, 48 h after surgery (P<0.05) and a higher sedation score at 6, 24 h after surgery than those in group C (P<0.05). Conclusion Besides offering effective analgesia, postoperative dexmedetomidine infusion has positive effects on sleep disturbance in patients undergoing hysterectomy. |
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