Comparative Study of Efficacy and Safety of Different Doses of Dexmedetomidine Combined with Sufentanil and Dezocine for Patient-controlled Intravenous Analgesia after Gynecological Surgery

ZHONG Xianmei; LI Yixian; KANG Zhenming

doi:10.14033/j.cnki.cfmr.2025.16.001

Abstract：Objective:To investigate the effect of different doses of Dexmedetomidine(DEX)combined with Sufentanil(SUF)and Dezocine(DEZ)for patient-controlled intravenous analgesia(PCIA)on postoperative pain,nausea and vomiting(PONV),and sleep quality in gynecological surgery patients.Method:A total of 99 patients who underwent gynecological surgery in Quanzhou First Hospital Affiliated to Fujian Medical University from June 2021 to May 2024 were selected,and they were divided into group C,group L and group H by random number table method,with 33 cases in each group.Postoperative PCIA was performed for 48 h of continuous analgesia.Group C given 1.5 μg/kg SUF+0.3 mg/kg DEZ,group L was given 1.5 μg/kg DEX+1.5 μg/kg SUF+0.3 mg/kg DEZ,group H was given 3.0 μg/kg DEX+1.5 μg/kg SUF+0.3 mg/kg DEZ.The recovery quality,pain degree at each time point after operation[visual analogue scale(VAS)],sleep quality before and after operation[Athens insomnia scale(AIS)]and the incidence of adverse reactions within 7 d after operation were compared among three groups.Result:The time of spontaneous breathing recovery,awakening and extubation in group C were longer than those in group L and group H,and the times of PCIA pressing and remedial analgesia were more than those in group L and group H,the differences were statistically significant(P<0.05);however,there were no significant differences in the recovery quality between group L and group H(P>0.05).At 6 h,12 h and 24 h after operation,the VAS scores of three groups were lower than those at 1 h after operation,and the differences were statistically significant(P<0.05);there were no significant differences in VAS scores between the three groups at 1 h and 24 h after operation(P>0.05).the VAS scores of group L and group H at 6 h and 12 h after operation were lower than those of group C,and the differences were statistically significant(P<0.05),there was no significant difference between group L and group H(P>0.05).At 1 d before operation,there was no significant difference in AIS scores among three groups(P>0.05);at 1 d and 7 d after operation,the AIS scores of three groups were higher than those at 1 d before operation,and the AIS scores of group L and group H were lower than those of group C,the differences were statistically significant(P<0.05),there was no significant difference between group L and group H(P>0.05).There was no significant difference in the incidence of adverse reactions within 7 d after operation among three groups(P>0.05).Conclusion:Different doses of DEX combined with SUF and DEZ for PCIA can enhance the sedative and analgesic effects of patients undergoing gynecological surgery,have no effect on PONV,and improve sleep quality;compared with low-dose,high-dose DEX combined with PCIA did not significantly enhance the sedative effect.