Sufentanil Combined With Dexmedetomidine for Analgesia After Hyperthermic Intraperitoneal Chemotherapy S / 中国微创外科杂志

ABSTRACT

Objective To evaluate the analgesic efficiency of patients controlled intravenous analgesia ( PCIA) with sufentanil and dexmedetomidine after hyperthermic intraperitoneal chemotherapy ( HIPC) . Methods A total of 45 patients undergoing HIPC were randomly divided into 3 groups with 15 in each group .They received PCIA after operation with a background infusion rate of 2 ml/h, a loading dose of 2 ml, a lockout time of 15 min, and a liquid volume of 100 ml.The PCIA formulation in each group was as followsgroup A (sufentanil 3.0 μg/h), group B (sufentanil 2.0 μg/h), and group C (sufentanil 2.0 μg/h +dexmedetomidine 4.0 μg/h).The VAS, Ramsay sedation scale, patient pressing times, and the adverse effects were recorded at 1 h (T1), 2 h (T2), 6 h (T3), 12 h (T4), 24 h (T5), and 48 h (T6) after surgery.Results The VAS scores of the group B were higher than those in the other two groups at T3-T6 time points [T3(2.9 ±0.5) points vs.(3.5 ±0.8) points, q=3.600, P<0.05, (2.8 ±0.6) points vs.(3.5 ±0.8) points, q=4.200, P<0.05;T4(2.4 ±0.6) points vs.(2.9 ±0.7) points, q=3.049, P<0.05;(2.3 ± 0.6) points vs.(2.9 ±0.7) points, q=3.659, P<0.05;T5(1.9 ±0.6) points vs.(2.5 ±0.5) points, q=3.838, P<0.05;(1.8 ±0.7) points vs.(2.5 ±0.5) points, q=4.477, P<0.05;T6(1.6 ±0.5) points vs.(2.0 ±0.4) points, q=3.303, P<0.05;(1.5 ±0.5) points vs.(2.0 ±0.4) points, q=4.129, P<0.05].The Ramsay scores of the group A were statistically higher than those of the group B at T5 and T6 [T5(2.5 ±0.5) points vs.(2.1 ±0.5) points, q=2.893, P<0.05;T6 (2.3 ±0.5) points vs.(1.9 ±0.3) points, q=3.493, P<0.05].The Ramsay scores of the group B were statistically lower than those of the group C at T3-T6 [T3(2.4 ±0.5) points vs.(3.1 ±0.7) points, q=4.477, P<0.05; T4 (2.2 ±0.4) points vs.(2.8 ± 0.7) points, q=4.243, P<0.05;T5(2.1 ±0.5) points vs.(2.6 ±0.6) points, q=3.617, P<0.05;T6(1.9 ±0.3) points vs.(2.4 ±0.5) points, q=4.367, P<0.05].The incidence of nausea and vomiting in the group A was higher than that in the group C [7 cases (46.7%) vs.1 case (6.7%),χ2 =4.261, P=0.039], while there were no differences between group B and C and between group A and B (P>0.05).The number of pressing times in the group B was more than that in the other two groups [(5.3 ±2.6) times vs.(8.4 ±4.2) times, q=3.662, P<0.05; (4.5 ±2.8) times vs.(8.4 ±4.2) times, q=4.608, P<0.05 ] . Conclusion Dexmedetomidine can reduce postoperative consumption of sufentanil in patients undergoing HIPC and decrease the incidence of nausea and vomiting .