喷他佐辛与曲马多预防瑞芬太尼麻醉后急性疼痛的效果比较  

Comparison of pentazocine and tramadol on prevent postoperative hyperalgesia in remifentanil-based general anesthesia

作　　者：彭为平[1] 莫平[1] 黄小琼[2] 刘茂东[1] 邵泳尧[1] 

机构地区：[1]南方医科大学附属南海医院麻醉科,广东佛山528200 [2]南方医科大学附属南海医院医务部,广东佛山528200

出　　处：《中国新药与临床杂志》2013年第2期150-153,共4页Chinese Journal of New Drugs and Clinical Remedies

摘　　要：目的比较喷他佐辛与曲马多预防瑞芬太尼麻醉后急性疼痛的疗效及安全性。方法选择妇科择期腹腔镜手术女性患者40例,年龄19～58岁,ASAⅠ～Ⅱ级,随机分为喷他佐辛组和曲马多组,每组20例。两组均静脉血浆靶控输注丙泊酚与瑞芬太尼气管插管全身麻醉,手术结束时喷他佐辛组静脉注射喷他佐辛0.5 mg·kg-1,曲马多组静脉注射曲马多1 mg·kg-1。记录术毕至苏醒时间、拔管时间,评定拔管后RSS评分及拔管后10、30 min的VRS评分,并记录需要追加哌替啶镇痛的例次,观察两组不良事件。结果喷他佐辛组苏醒时间(5.5±1.1)min、拔管时间(7.1±1.0)min、拔管后RSS评分中位数2.5分;曲马多组苏醒时间(5.3±0.9)min、拔管时间(6.7±0.8)min、拔管后RSS评分中位数3分,两组无显著差异(P>0.05)。喷他佐辛组拔管后10、30 min的VRS评分中位数均为1分,追加哌替啶3例;曲马多组拔管后10、30 min的VRS评分中位数均为2分,追加哌替啶9例。AIM To investigate and compare the efficiency and safety of pentazocine and tramadol on prevention of postoperative hyperalgesia induced by remifentanil based general anesthesia. METHODS Forty female patients, aged 19 - 58 years, who volunteered to receive gynaecological laparoscopic operation （ASA I - II ）, were randomly divided into two groups （20 in each）. All patients received general anesthesia with plasma target- controlled infusion of propofol and remifentanil. At the end of the surgery, patients in the pentazocine group were given intravenous injection of pentazocine 0.5 mg .kg-~ and the others in the tramadol group were given intravenous injection of tramadol 1 mg. kg-＇. The time needed from the end of the operation to awake and extubation, the adverse events were observed and recorded. The Ramsay sedation scales （RSS） scores after extubation, verbal rating scales （VRS） recorded at 10 rain and 30 min after extubation, and incident of additional used of pethidine were recorded. RESULTS There were no significant differences in the time from the end of the operation to awake and extubation between pentazocine group and tramadol group （（5.5 ± 1.1 ） min vs. （5.3 ± 0.9） min, and （7.1 ± 1.0） min vs. （6.7 ± 0.8） min, P 〉 0.05））. The adverse events during recovery period and median RSS after extubation had not significant difference between two groups （2.5 vs. 3, P 〉 0.05）. The VRS in the pentazocine group at 10 min and 30 min after extubation were lower than those in the tramadol group （both 1 vs. 2, P 〈 0.05） and the incident of additional used of pethidine was lower in the pentazocine group （3 patients vs. 9 patients, P 〈 0.05）. CONCLUSION Administration of pentazocine at the end of operation can significantly prevent the postoperative hyperalgesia in remifentanil-based general anesthesia compared with tramadol, without delay the postoperative extubation.

关 键 词：喷他佐辛 曲马多 疼痛 手术后 瑞芬太尼 

分 类 号：R971[医药卫生—药品]