不同剂量舒芬太尼用于肝癌切除术后镇痛效果的比较  

Different dose of sufentanil for postoperative patient-controlled intravenous analgesia after resection of liver cancer

作　　者：张加强[1] 赵素真[1] 孟凡民[1] 牛全玉[1] 

机构地区：[1]河南省人民医院麻醉科,郑州市450003

出　　处：《实用诊断与治疗杂志》2008年第4期264-266,共3页Journal of Practical Diagnosis and Therapy

摘　　要：目的:比较不同剂量舒芬太尼用于肝癌切除术患者静脉镇痛的临床效果和安全性,以探讨合适的镇痛剂量。方法:肝癌切除术患者60例,随机分为三组,S1组舒芬太尼术后镇痛剂量为0.02μg/(kg.h),S2组为0.04μg/(kg.h),S3组为0.06μg/(kg.h)。分别于术后4、12、244、8 h记录视觉模拟评分法(VAS评分)、运动评分(VAFS评分)、镇静评分(White评分)、平均动脉压(MAP)、心率(HR)、呼吸频率(RR)、血氧饱和度(SpO2)。并于48 h后记录镇痛总体满意度评分和不良反应(恶心、呕吐、皮肤瘙痒)。结果:S1组4、12、24 h的VAS评分及VAFS评分与S2组、S3组比较差异有统计学意义(P<0.05),S2组4 h时的VAFS评分与S3组比较差异有统计学意义(P<0.05)。S3组41、2 h的White评分与S1组、S2组比较差异有统计学意义(P<0.05)。S3组的RR在术后4 h时明显低于S1组(P<0.05)。S1组的镇痛满意度评分与S2组、S3组比较差异有统计学意义(P<0.05),S2组与S3组比较差异无统计学意义。结论:肝癌切除术患者术后静脉持续输注0.04μg/(kg.h)舒芬太尼,可提供较好的镇痛效果,不良反应少。Objective To compare the clinic effect and safety of different dose of sufentanil for postoperative patient-controlled intravenous analgesia after resection of liver cancer. Methods Sixty patients aged from 40 to 55 years weighing 45-75 kg scheduled for resection of liver cancer under general anesthesia were divided into 3 groups （n = 20 each） = group S1 receiving patient-controlled intravenous analgesia with sufentanil 0.02 μg/（kg · h） ; group S2 sufentanil 0.04 μg/（kg · h） and group S3 sufentanil 0.06 μg/（kg · h）. Visual analogue scale（VAS）, VAFS, sedation scores, vital signs （MAP, HR, RR, SpO2）were assessed after 4, 12, 24 and 48 hours of of postoperative analgesia. The scores of satisfaction of postoperative analgesia and the adverse reations including nausea, emesis, pruritus and resperitory inhibition were recorded. Results After 4, 12 and 24 hours of postoperative analgesia, VAS and VAFS scores were higher in group S1 than group S2 and group S3 （P〈0.05）. After 4 hours of postoperative analgesia, VAFS scores were higher in group S2 than group S3（P〈0.05）. After 4 and 12 hours of postoperativea nalgesia, White scores were higher in group S3 than group S1 and group S2 （P〈0.05）. After 4 hours of postoperative analgesia, RR was slower in group S3 than group S1（P〈0.05）. The scores of Satisfaction of postoperative analgesia were higher in group S1 than group S2 and group S3 （P〈0.05）. The incidence of adverse events including the adverse reactions （nausea, emesis, pruritus） was lower. Conclusion Sufentanil 0.04 μg/ （kg · h） for postoperative analgesia after resection of liver cancer provides better analgesia effect, and the adverse reaction is fewer.

关 键 词：肝癌切除术 舒芬太尼 术后镇痛 

分 类 号：R614[医药卫生—麻醉学]