三种麻醉药用于腹腔镜下子宫全切术术后替代性镇痛的临床研究  

Clinic study of three kinds of anesthetics in postoperative replacement analgesia for patients with laparoscopic hysterectomy

作　　者：张云英[1] 

机构地区：[1]沈阳市妇婴医院麻醉科,辽宁沈阳110014

出　　处：《中国现代医生》2013年第2期76-77,共2页China Modern Doctor

摘　　要：目的评价曲马多、芬太尼、舒芬太尼用于瑞芬太尼和丙泊酚静脉复合麻醉的腹腔镜下子宫全切术术后替代性镇痛的临床效果和安全性。方法 ASAⅠ～Ⅱ级择期行腹腔镜下子宫全切术患者90例,随机分为三组,每组30例,分别于停用瑞芬太尼后静脉注射曲马多1.5 mg/kg(Q组)、舒芬太尼0.1μg/kg(S组)、芬太尼1μg/kg(F组)。对三组术后疼痛和不良反应进行评价。结果三组患者于拔管后5 min、15 min的VAS评分无差异,30min时VAS评分F组、S组明显低于Q组(P<0.05),F组与S组间比较,差异无统计学意义(P>0.05)。1 h、2 h时曲马多和芬太尼组间差异无统计学意义,而两组与舒芬太尼组差异有统计学意义。结论曲马多、芬太尼与舒芬太尼均可用于腹腔镜下子宫全切术术后替代性镇痛,并以舒芬太尼效果尤佳。Objective To evaluate the efficacy and safety of tramadol, fentanyl and sufentanil in postoperative re- placement analgesia of remifentanil with propofol for total intravenous anesthesia for patients with laparoscopic hys- terectomy. Methods Ninety patients of ASA class Ⅰor Ⅱ scheduled for selective laparoscopic hysterectomy were ran- domLy allocated into three groups for receiving with tramadol 1.5 mg/kg （group Q,n = 30）, fentanyl lμg/kg （group F,n = 30）,and sufentanil 0.1μg/kg （group S,n = 30） after stopping intravenous pumping remifentanil and propofo｜. To evaluate the postoperative pain and adverse reactions about the three groups of patients. Results There were no significant differences in VAS at 5 rain, 15min among group Q ,group F with that in group S . There were no signifi- cant differences in VAS between group Q and group Fat 30 min. VAS scores in group S were higher than that in group Q and group F at 30 min. There were no significant differences in VAS at 1 h, 2 h between group Q with that in group F. There were significantly different in VAS at lh, 2h between both of group Q and group F with that in group S. Conclusion Tramadol, fentanyl and sufentanil can be used in total intravenous for patients with laparoscopic hysterectomy, and sufentanil effect is a plus.

关 键 词：曲马多 芬太尼 舒芬太尼 替代性镇痛 

分 类 号：R614[医药卫生—麻醉学]