Effect Of Combining Dexmedetomidine And Sufentanil For Postoperative Intravenous Patient-controlled Analgesia In Patients Undergoing Urological Laparoscopic Surgery

Objective: This study aimed to compare the efficacy and safety of combingdexmedetomidine and sufentanil with sufentail alone for postoperative intravenouspatient-controlled analgesia in patients undergoing urological laparoscopic surgery and itseffects on hemodynamics.Methods: Sixty patients undergoing urological laparoscopic surgery were included inthis study. All the patients met following criteria: ASAⅠ~Ⅱ,20-65years old,45-85kg. Allthe enrolled patients received general anesthesia, and postoperative PCIA was applied.They were randomly divided into three groups according to different analgesic formula.There are20patients in each group.Patients in A group received PCIA with sufentanil0.04μg/kg/h. Patients in B group received PCIA with sufentanil0.04μg/kg/h anddexmedetomidine0.15μg/kg/h. Patients in C group received PCIA with sunfentanil0.0625μg/kg/h. The entire PCIA regimen included a background infusion at2ml/h with a1ml bolus dose and a30min lockout interval. The VAS and Ramesay scores inpostoperative1h、2h、4h、24h were recorded.PCA demands were recorded inpostoperative24h. BP, HR and SPO2were also recorded at baseline, postoperative15min,30min,1h,2h,4h, and24h. The incidences of bradycardia, hypotension, nausea, vomitingand shivering were also collected during postoperative period.Results:1.The VAS score in A group was significant higher than B and C group inpostoperative1h,2h,4h,24h(2.10±0.64,2.70±0.80,2.90±0.55,3.10±0.74VS1.30±0.80,1.85±0.81,1.65±0.74,1.65±0.58and2.0±0.72,2.05±0.94,1.95±0.60,1.90±0.44,P﹤0.05). TheVAS score was lower in B group than C group in postoperative1h,4h,24h (1.30±0.80,1.65±0.74,1.650.58vs.2.00±0.72,1.95±0.60,1.90±0.44, P﹤0.05). 2.There was no significant difference in Ramsey sedation score (P﹥0.05).3.PCA demands was higher in A group than B and C group (8.25±0.42vs5.60±0.37and5.80±0.34, P﹤0.05).4.Each group maintained stable hemodynamics and had no respiratory depression (P﹥0.05).5.The incidence of nausea, vomiting and shivering in group A and group C werehigher than those of group B (P <0.05).Conclusions: The analgesia effect of combining dexmeditomidine with sufentanil wasbetter than sufentanil alone. It had no effect on respiratory depression, maintained stablehemodynamics and had few adverse effects.