丙帕他莫超前镇痛用于腹腔镜胆囊切除术的临床观察  

Clinical Observation of Propacetamol Hydrochloride Applied in Preemptive Analgesia of Laparoscopic Cholecystectomy

作　　者：曾东[1] 古军[1] 何东江 陈余[1] 

机构地区：[1]雅安市人民医院麻醉科,四川雅安625000

出　　处：《西南军医》2015年第2期136-138,共3页Journal of Military Surgeon in Southwest China

摘　　要：目的观察丙帕他莫超前镇痛用于腹腔镜胆囊切除术的临床效果和安全性。方法 90例ASA I~Ⅱ级拟行腹腔镜胆囊切除术患者随机分为A组、B组和C组,每组30例。麻醉诱导前15 min,A组将盐酸丙帕他莫2g溶入100 ml生理盐水静脉滴入;B组按照布托啡诺20μg/kg计算用量,用生理盐水稀释至100 ml静脉滴入;C组静脉滴注生理盐水100 ml。观察并记录术后患者自主呼吸恢复时间、麻醉苏醒时间、拔管时间。采用视觉模拟镇痛评分法（VAS）评价三组患者术后1h、2h、4h、8h和24 h疼痛程度,同时观察嗜睡、烦躁、恶心呕吐、呼吸抑制等不良反应。结果与B组比较,A组和C组的苏醒时间、拔管时间均明显缩短（P〈0.05）,A组与C组间比较无统计学意义（P〉0.05）;与C组比较,A组和B组患者在术后2h、4h、8h和24h的VAS评分明显降低（P〈0.05）;A组和C组术后嗜睡例数明显少于B组（P〈0.05）,三组均未发生呼吸抑制,烦躁、恶心呕吐不良反应发生率无统计学意义（P〉0.05）。结论丙帕他莫超前镇痛用于腹腔镜胆囊切除术具有显著的术后镇痛作用,且不影响患者的苏醒质量,不增加术后不良反应。Objective To observe the clinical effect and the safety of propacetamol hydrochloride applied in preemptive analgesia of laparoscopic cholecystectomy. Methods 90 cases to receive laparoscopic cholecystectomy with ASA grading from I to II were randomly divided into 3 groups： Group A, Group B and Group C, 30 cases in each; 15 minutes before anesthesia, infusion of propacetamol hydrochloride（2g diluted in 100 ml saline） was made to cases in Group A, infusion of butorphanol with the dosage calculation of 20μg/kg diluted in 100 ml saline was made to cases in Group B and infusion of 100 ml saline was made to cases in Group C; the recovery time of spontaneous respiration after operation, the anesthesia awaking time and the extubation time of the cases in the 3 groups were observed and recorded; visual analogue scale（VAS） was applied in assessing the pain degrees of the cases in the 3 groups at the time point of 1 hour, 2 hours, 4 hours, 8 hours and 24 hours after operation; side effects were observed as well, such drowsiness, fidgety, nausea,vomiting and respiratory depression. Results The anesthesia awaking time and the extubation time in Group A and Group C were much shorter than that in Group B（P〈0.05）, there existed no statistical difference between Group A and Group C（P〉0.05）; the VAS scores in Group A and Group B at the time point of 2 hours, 4 hours, 8 hours and 24 hours after operation dropped down much more than those in Group C（P〈0.05）; the case numbers of drowsiness in Group A and Group C were obviously less than that in Group B（P〈0.05）; no respiration depression occurred in the 3 groups, and the occurrence of fidgety and vomiting was of no statistical significance（P〉0.05）. Conclusions The application of propacetamol hydrochloride in preemptive analgesia of laparoscopic cholecystectomy is of obvious analgesic effect with no impact on the awaking of patients from anesthesia after operation or occurrence of side effects.

关 键 词：丙帕他莫 超前镇痛 腹腔镜胆囊切除术 

分 类 号：R657.4[医药卫生—外科学]