Clinical Evaluation Of Different Doses Of Dexmedetomidine For Postoperative Patient-controlled Intravenous Analgesia In Patients With Gynecological Benign Tumors

Purpose:To compare the clinical feasibility,patient comfort,drug safety and related adverse reactions of the same dose of sufentanil combined with different doses of dexmedetomidine in postoperative patient-controlled intravenous analgesia in patients with gynecological benign tumors.method:From June 2021 to October 2021,60 female patients who underwent three hole laparoscopic surgery to remove benign tumors in China Japan Friendship Hospital of Jilin University were randomly selected.All patients had ASA score of grade I-II,age between 30-55 years and BMI of 20-24.They were healthy in the past and had no confirmed related diseases.They agreed to undergo postoperative patient-controlled intravenous analgesia（PCIA）.With the help of random number table method,60 samples of this experiment were randomly divided into groups.The grouping was as follows:（1）sufentanil only group（group A,n = 20）: sufentanil 2.0 μ G / kg + 3mg granisetron;Low dose dexmedetomidine group（group B,n = 20）: sufentanil 2.0 μg/kg+1.5 μ G / kg dexmedetomidine + 3mg granisetron;High dose dexmedetomidine group（Group C,n = 20）: sufentanil 2.0 μ g/kg+3.0 μ G / kg dexmedetomidine + 3mg granisetron.PCIA preparation and use method: after all drugs are mixed with 0.9%normal saline,they are prepared to 100 ml and continuously injected at the speed of2 ml / h throughout the use process.The safety time of automatic locking is set to15 min,and the automatic impact dose for each time is 0.5ml,a total of 48 h from the beginning to the end of use.If the patient uses intravenous analgesics for continuous pain in the anesthesia recovery room or ward and does not alleviate,he will withdraw from the experiment.The following data were recorded: the heart rate（HR）,mean arterial pressure（map）and blood oxygen saturation（Sp O2）of the three groups were recorded at five time points: one day before operation（T0）,6h（T1）,12h（T2）,24h（T3）and 48h（T4）;The subjective data of patients at T1-T4 were recorded: analgesia score（NRS score）,sedation score（modified OAAs score）and comfort score（BCS score）;The anxiety score（SAS score）and sleep score（AIS score）of patients at t0 and T4 were recorded;The number of patient-controlled pulse analgesia within 48 hours of PCIA was recorded;The adverse reaction events within 48 hours after using PCIA were recorded;The patient’s disease type,operation method,operation time,anesthesia time,intraoperative bleeding,total amount of sufentanil and total amount of remifentanil were recorded.result:There was no difference in ASA grade,disease type,operation method,operation and anesthesia time,intraoperative bleeding,total use of sufentanil and remifentanil among the three groups.（P>0.05）。The HR and map in group A were higher than those in group B and C at four time points（P < 0.05）.B.C comparison between the two groups: the HR of patients in low-dose dexmedetomidine group was greater than that in high-dose dexmedetomidine group at four time points（P < 0.05）.There was no significant difference in map between the two groups（P > 0.05）.Comparison of Sp O2 among the three groups: there was no significant difference in Sp O2 among the three groups at each time point before and after operation（P >0.05）.The postoperative NRS scores of the three groups were higher in group A than in group B and C（P < 0.05）.,There was no significant difference between group B and group C（P > 0.05）.The SAS score and AIS score of the three groups at two time points: group A was greater than that of group B and C（P < 0.05）.There was no significant difference between group B and group C（P > 0.05）.The improved OAAs scores of the three groups at four time points: group B and group C were higher than group A at four time points（P < 0.05）.,There was no significant difference between group B and group C（P > 0.05）.BCS score of comfort in the three groups: at four time points,group B and group C were higher than group A（P < 0.05）.,There was no significant difference between group B and group C（P > 0.05）.Adverse reactions in the three groups: adverse reactions occurred in all three groups.The total number of adverse reactions in group A was greater than that in group C and greater than that in group B（P < 0.05）.There was no significant difference between low-dose dexmedetomidine group and high-dose dexmedetomidine group（P > 0.05）.There were 1 case of constipation,2 cases of skin pruritus,6 cases of nausea and vomiting,1 case of bradycardia in group B and 2 cases of bradycardia in group C.The press times of patient-controlled analgesia in group A were significantly higher than those in group B and C（P < 0.05）.Group B was slightly higher than group C（P > 0.05）.The three groups of patients did not carry out analgesic remedy in the ward Conclusion:Sufentanil combined with different doses of dexmedetomidine for postoperative patient-controlled intravenous analgesia in patients with gynecological benign tumors has definite effect,stable respiratory and circulatory indexes,high subjective comfort,effectively reduces the patient’s pain score,improves the patient’s anxiety level,improves the patient’s sleep quality,and better controls the postoperative adverse drug reaction events;Among them,sufentanil 2.0 μ G / kg composite 1.5 μ G / kg dexmedetomidine has better comprehensive effect.