Efficacy Of Different Doses Of Dexmedetomidine Assistant With Sufentanil On The PCIA After Hysterectomy

ObjectivesTo evaluate the effects of different doses of dexmedetomidine assistant with sufentanil on the efficacy of patient-controlled intravenous analgesia after hysterectomy.MethodsEighty patients, who were Voluntary to use self-controlled intravenous analgesia pump in the treatment of elective general anesthesia abdominal type of operation of total hysterectomy, aged from30to60years old and ASA grade Ⅰor II,came admitted to our hospital from July2011to January2012and were randomly divided into4groups:group S sufentanil and three groups of D1, D2and D3. Different doses of dexmedetomidine plus sufentanil. Group S is sufentanil0.04μg/kg-h, GroupD1, D2、 D3are dexmedetomidine (0.08、0.09、0.10)μg-kg-1·h-1plus sufentanil0.02μg·kg-1·h-1separately, PCIA was started immediately after operation. Patients’grades of analgesia and sedation in1h,6h,12h,24h and48h after the operation, Patient controlled analgesia bolus, the change of blood pressure, heart rate, pulse oxygen saturation, breathing frequency and the total evaluation of adverse and48h analgesia effect after the operation are recorded.To evaluate the analgesic level using VAS scores.To evaluate the sedation level using Ramsay scores.ResultsCompared to the group S, the VAS score of group D2and D3become lower in the postoperative6h,12h (P<0.05), but the VAS score of group D1become higher in the postoperative6h,12h (P<0.05).The Effective press times of Group D1’s PCA increased significantly (P<0.05). In D2group, D3group and S group, there is no significant difference between the number of PCA (P<0.05).Group S, D2and D3were able to achieve the target analgesia level, and each time point VAS<4(P<0.05). Compared to the group S,the Ramsay grades of group D1become lower (P<0.05), the Ramsay grades of group D2and D3become higher (P<0.05). Four groups were not deep sedation, Ramsay score<4(P<0.05).Four groups of breathing frequency changes were no significant differences (P<0.05).The hemodynamic of group D2become more calm in l-48h after the operation. The occurrences of adverse effects of group D1, D2and D3become lower in evidence (P<0.05). The satisfaction of48h analgesia effects after the operation of group D2and D3raise (P<0.05).ConclusionsThe dose of0.09μg·kg-1h-1of dexmedetomidine can make an obvious effect on the efficacy of patient-controlled intravenous analgesia after the operation,to maintain the stabilization of hemodynamic,to reduce the related adverse effects and to improve the patients’analgesia after the operation.