预先镇痛对全宫术后全麻恢复期病人听觉诱发电位(AEP)的影响  

Effect of preemptive analgesia on postoperative patient’s auditory evoked potential (AEP) after complete hysterectomy under general anesthesia

作　　者：张毅[1] 刘凌云[1] 张咸伟[1] 田玉科[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院麻醉学教研室,武汉430030

出　　处：《中国优生与遗传杂志》2005年第7期80-81,85,共3页Chinese Journal of Birth Health & Heredity

摘　　要：目的观察预先镇痛是否影响术后病人意识恢复程度。方法选择40例ASAI-Ⅲ级行全宫切除术的病人,随机分为对照组(n=20)和预先镇痛组(n=20),所有病人均在静-吸复合麻醉下完成手术。预先镇痛组在手术开始前使用曲马多1·5mg·kg-1,术后入苏醒室,记录AEP、VAS镇痛评分和术后寒颤和躁动的发生率。结果①VAS:预先镇痛组优于对照组(P<0·05);②OAA/S评分和AEP:在5min和10min2个时间点,OAA/S评分,预先镇痛组低于对照组(P<0·05),而AEP在各个时间点,预先镇痛组均低于对照组(P<0·05);③术后寒颤和躁动的发生率:预先镇痛组明显低于对照组。结论预先镇痛使术后患者意识恢复程度有一定程度的延长,但不会造成苏醒延迟。并且预先镇痛使患者苏醒后AEP值有所降低。Objective: To observe whether preemptive analgesia affect recovering degree of awareness in postoperative patients. Methods:Forty patients for complete hysterectomy were randomly assigned to control group (n=20) and preemptive analgesia group (n=20). All patients had been completed the operations under general anesthesia. Before operation, Patients in the preemptive analgesia group was given tramadol 1.5mg.kg -1 intravenously. After operation, all patients were transported into recovering room. OAA/S sedation Score, VAS, BIS and ratio of postoperative shaking chill and harass were recording.Results: ①VAS: preemptive analgesia group was much better than control group. (P<0.05).②OAA/S was significantly lower in preemptive analgesia group than control group at 5 and 10 min after extubation. But AEP was significantly lower in preemptive analgesia at all times after extubation.③The ratio of postoperative shaking chill and harass were also significantly lower in preemptive analgesia group than control group. Conclusion: Preemptive analgesia, to some extent, may affect the awareness after general anesthesia. But it couldn’t cause awareness delay. Preemptive analgesia may also cause AEP decreased to some extent.

关 键 词：听觉诱发电位 预先镇痛 

分 类 号：R614[医药卫生—麻醉学]