肝癌切除术后应用右美托咪定复合舒芬太尼和布托啡诺静脉自控镇痛效果研究*

doi:10.3969/j.issn.1672-5069.2025.02.027

Abstract

Abstract: Objective The purpose of this study was to investigate efficacy of self-controlled intravenous analgesia of dexmedetomidine and sufentanil and butorphanol combination in patients with primary liver cancer (PLC) after laparoscopic hepatectomy (LH). Methods 72 patients with PLC were enrolled in our hospital between January 2020 and December 2023, and all underwent LH for resection of liver cancer. For post-operational analgesia after surgery, patients were randomly divided into control (n=36) and observation (n=36) groups, receiving intravenous pumping of sufentanil and butorphanol or sufentanil, butorphanol and dexmedetomidine combination by self-controlled way. Body pain was evaluated by visual analogue scale (VAS). Serum neuropeptide Y (NPY), substance P (SP) and 5-hydroxytryptamine (5-HT) levels were assayed by RIA, and serum cortisol (Cor), catecholamine (CA) and adrenocorticotropic hormone (ACTH levels were detected by ELISA. Results Recovery of autonomous respiration and waking in the observation group(16.7±2.2)min and (19.3±2.4)min, both much shorter than [(21.2±2.7)min and (23.8±3.1)min, respectively, P＜0.05] in the control; by 24 hours and 48 hours after operation, VAS scores in the observation were (1.6±0.3)points and (1.0±0.2)points, both significantly lower than [(2.1±0.4)points and (1.9±0.3)points, P＜0.05] in the control; by 24 hours after surgery, serum NPY, SP and 5-HT levels in the observation were (41.8±8.6)pg/mL, (52.5±10.4)pg/mL and (0.4±0.1)μmol/L, all significantly lower than [(54.4±10.7)pg/mL, (79.5±13.8)pg/mL and (0.5±0.1)μmol/L, respectively, P＜0.05] in the control; serum Cor, CA and ACTH levels were (211.5±29.0)nmol/L, (216.6±29.7)pg/mL and (6.6±1.3)pg/mL, all much lower than [(265.6±25.8)nmol/L, (240.7±26.3)pg/mL and (8.4±1.5)pg/mL, respectively, P＜0.05] in the control group. Conclusion The application of dexmedetomidine combined with sufentanil and butorphanol for analgesia in patients with PLC after LH have a perfect efficacy, which might be related to inhibition of stress reaction.

Key words: Hepatoma, Laparoscopic hepatectomy, Dexmedetomidine, Sufentanil, Butorphanol, Analgesia, Stress reaction

Zhang Hua, Zhong Huanhui, Kuang Yanchun, et al. Patient-controlled intravenous analgesia of dexmedetomidine and sufentanil and butorphanol combination in patients with primary liver cancer after laparoscopic hepatectomy[J]. Journal of Practical Hepatology, 2025, 28(2): 266-269.

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Patient-controlled intravenous analgesia of dexmedetomidine and sufentanil and butorphanol combination in patients with primary liver cancer after laparoscopic hepatectomy

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