芬太尼用于妇科腹腔镜手术瑞芬太尼麻醉后疼痛过敏防治的临床观察  

作　　者：钟剑洪 卫凤英 李婉丽 刘妙雯 

机构地区：[1]佛山市顺德妇幼保健院麻醉科,528300 [2]佛山市顺德桂州医院

出　　处：《当代医学》2009年第24期148-149,共2页Contemporary Medicine

摘　　要：目的研究芬太尼(3μg/kg)防治瑞芬太尼复合麻醉术后疼痛过敏的临床疗效。方法妇科腹腔镜手术的患者52例,随机分为芬太尼组和芬太尼+氟派利多组,每组26例.芬太尼组(A组)和芬太尼+氟派利多组(B组)分别于手术结束前20min静脉滴注芬太尼(3μg/kg)和氟派利多(0.05mg/kg)+芬太尼(1μg/kg),所有患者在手术结束前10min停止吸入异氟醚和泵注异丙酚,手术结束时停止泵注瑞芬太尼,比较两组患者自主呼吸恢复、意识恢复和拔管时间,以及患者恢复期的疼痛程度和拔管后需要追加芬太尼的例数以及恶心呕吐寒颤的发生率。结果A组和B组患者的自主呼吸恢复时间、意识恢复时间、拔管时间和恶心呕吐寒颤的发生率在统计学上没有显著性差异,A组术后发生中等和严重疼痛的人数明显少于B组(P<0.05),而且A组拔管后需要2次追加芬太尼的人数也少于B组(P<0.05),后者约有50%的患者拔管后需要两次追加芬太尼。结论手术结束前20min静脉用芬太尼(3μg/kg)能够有效防治妇科腹腔镜手术停止麻醉后因超短效阿片类药物瑞芬太尼的快速代谢而引起的术后疼痛过敏,并且促进自主呼吸恢复和意识恢复。Objective To study the fentanyl （3μg/kg） control remifentanil anesthesia for postoperative pain relief allergy clinical efficacy. Methods Patients with gynecologic laparoscopic surgery 52 cases were randomly divided into fentanil group and fentanyl add droperidol group of 26 cases, fentanil group （A group） and fentanyl add droperidol group （B group） separately in the surgery before the end of 20 min intravenous infusion of fentanyl （3μg/kg） and droperidol （0.05mg/kg） ＋ fentanyl （1μg/kg）, all patients in the surgery before the end of 10 min cessation of inhalation of isoflurane and propofol infusion, surgery to stop the end of remifentanil infusion, compared two groups of patients with spontaneous breathing resumed, the awareness of recovery and extubation time, as well as recovery of pain patients after extubation and required Example of a number of additional fentanyl as well as chills, nausea and vomiting incidence.Results A group and B group of patients with spontaneous breathing recovery time, consciousness recovery time, extubation time and nausea and vomiting the incidence of chills, there is no statistically significant difference, A group of moderate and severe postoperative pain in the number of obvious less than B group （P〈0.05）, and after extubation A group required additional fentanyl 2 times the number of less than B group （P〈0.05）, the latter about 50% of patients required twice after extubation additional fentanyl. Conclusion The operation before the end of 20 min of intravenous fentanyl （3μg/kg） can effectively prevent and treat gynecological laparoscopic surgery to stop narcotic effect due to ultra-short opiate rapid metabolism of remifentanil and postoperative pain caused by allergies, and to promote awareness of their own recovery and the resumption of breathing.

关 键 词：芬太尼 瑞芬太尼复合麻醉 疼痛过敏 

分 类 号：R614[医药卫生—麻醉学]