舒芬太尼和地佐辛预防瑞芬太尼麻醉后疼痛过敏效果比较  

作　　者：王桂平[1] 常立华[1] 张鹏[1] 白广[1] 

机构地区：[1]天津市大港油田总医院麻醉科,天津300280

出　　处：《当代医学》2015年第9期5-7,共3页Contemporary Medicine

摘　　要：目的比较舒芬太尼和地佐辛预防妇科腹腔镜手术瑞芬太尼复合麻醉术后疼痛过敏的临床疗效。方法选取行妇科腹腔镜手术的患者60例。随机分为舒芬太尼组(A组)、地佐辛组(B组)和空白对照组(C组),每组20例。A组和B组分别于手术结束前30 min静脉滴注舒芬太尼(0.05μg/kg)和地佐辛(0.1 mg/kg),60例患者均为结束手术前10 min停止泵注丙泊酚和吸入七氟烷,结束手术立即停止泵入瑞芬太尼,记录并比较3组患者的手术时间、手术停止至恢复自主呼吸及意识的时间、手术停止至拔除气管导管的时间;3组患者于拔管即刻(T1)、拔管后10 min(T2)及拔管后60 min(T3)的镇静评分(Ramsay)、视觉模拟评分(VAS);以及3组患者拔管后的恶心、呕吐及躁动等不良反应的发生例数。结果 A、B、C 3组患者的恢复自主呼吸时间、恢复意识时间和拔除气管导管时间差异无统计学意义。A、B组术后发生中等和严重疼痛的患者比例各占(0%、5%)明显低于C组(40%)(P<0.05);B组发生恶心8例、呕吐9例(各占40%、45%),高于A组(5%、10%)、C组(15%、10%),差异有统计学意义(P<0.05);C组的躁动发生率(60%)明显高于A组(5%)、B组(5%),差异有统计学意义(P<0.01)。结论手术结束前30 min静脉滴注舒芬太尼(0.05μg/kg)和地佐辛(0.1 mg/kg),均能够有效预防妇科腹腔镜瑞芬太尼所引起的术后疼痛过敏,但地佐辛的恶心呕吐的发生率较高。Objective To compare the effectiveness of sufentanil （0.05μg/kg） and dezocine （0.1mg/kg） at preventing hyperalgesia in remifentanil-associated gynecological laparoscopic surgery.Methods 60 participants receiving gynaecological laparoscopic operation from January to June 2014 were selected and randomLy placed in one of three groups： sufentanil group（group A）, dezocine group （group B） and control group （group C）, with 20 patients in each group. Participants in group A and B received sufentanil （0.05μg/kg） and dezocine （0.1mg/kg）, respectively, via intravenous infusion 30 minutes before their operation ended. All 60 participants were discontinued from propofol infusion and sevoflurane inhalation 10 minutes before their operation ended. Remifentanil infusion was stopped at the end of the operation. Duration of operation, recovery time for spontaneous respiration and consciousness, time required before tracheal extubation, pain scores （visual analogue scale） and sedation scores （Ramsay） at the moment of extubation （T1）, 10 minutes （T2） and 60 minutes （T3） after extubation were recorded and compared between groups. Post extubation nausea, vomiting, adverse reactions and agitation were also recorded.Results No statistically significant differences were found between groups A, B and C in recovery time for spontaneous respiration and consciousness and time required before tracheal extubation. Number of participants experiencing moderate to severe pain in groups A and B were significantly less than group C （P〈0.05）. Group A had fewer reports of nausea and vomiting than group B （P〈0.05）.Conclusion Administering sufentanil （0.05μg/kg） and dezocine （0.1mg/kg） 30 minutes prior to the end of operation can effectively prevent hyperalgesia in remifentanil-associated gynecological laparoscopic surgery. However, dezocine is associated with a higher incidence of nausea and vomiting.

关 键 词：舒芬太尼 地佐辛 瑞芬太尼 全身麻醉 疼痛过敏 

分 类 号：R614[医药卫生—麻醉学]