氟哌利多预先给药对妇科腹腔镜手术术后镇痛及舒适度的影响  

Effect of droperidol pretreatment on pain management and comfort in patients undergoing gynecologic laparoscopic surgery

作　　者：朱蓓蓓[1] 夏小萍[1] 顾小萍[1] 马正良[1] 

机构地区：[1]南京大学医学院附属鼓楼医院麻醉科,210008

出　　处：《国际麻醉学与复苏杂志》2015年第5期408-411,共4页International Journal of Anesthesiology and Resuscitation

摘　　要：目的观察预先静脉注射氟哌利多对妇科腹腔镜手术术后的镇痛效果及舒适度的影响。方法美国麻醉医师协会（ASA）分级Ⅰ～Ⅱ级择期行妇科腹腔镜手术的患者46例，按随机数字表法分成两组（每组23例）：氟哌利多组（D组，手术切皮前静脉注射氟派利多2．5mg）和对照组（C组，手术切皮前静脉注射生理盐水2ml）。记录两组患者一般情况（年龄、身高、体重）、手术时间，记录入手术室、诱导后、入麻醉后监测治疗室（post-anesthesia care unit，PACU）时、苏醒时、拔管后及离开PACU时患者的平均动脉压（mean arterial pressure，MAP）、心率（heanrate，HR），术后送入PACU观察停止麻醉后患者睁眼时间、拔管时间；记录拔管后即时及拔管后30min时Ramsay镇静评分及改良-Aldrete评分，拔管后30rain、lh及术后6、24h数字评价量表（numericalratingscale，NRS）评分及恶心呕吐、寒战等副作用的发生率。结果两组患者术前基础情况差异无统计学意义（P〉0．05）。NRS评分：拔管后30min、1h、术后6、24h时，D组[（1．4±1．3）、（1．7±1．5）、（1．5±1．5）、（0．9±0．8）分]与C组[（3．5±1．6）、（3．7±1．5）、（3．4±1．8）、（2．4±1．4）分]比较，差异均有统计学意义（P〈0．05）。两组各时间点MAP、HR等比较，差异无统计学意义（P〉0．05）。两组Ramsay镇静评分及改良-Aldrete评分比较，差异无统计学意义（P〉0．05）。C组恶心呕吐发生率高于D组，差异有统计学意义（P〈0．05）；两组患者均未出现苏醒后呼吸抑制、精神障碍、锥体外系反应等副作用。结论预先静脉给予氟哌利多有良好的术后镇痛效果，同时可降低术后恶心呕吐的发生率，提高患者舒适度。Objective To evaluate the effect of droperidol pretreatment on postoperative pain and comfort in patients undergoing gynecologic laparoscopic surgery. Methods Forty-six female patients undergoing gynecologic laparoscopic surgery were divided into two groups randomly（n=23 ）： the patients were treated with droperidol intravenously（group D ）, while patients were given with placebo as control （group C）. General characteristics of patients in two groups were recorded, including age, height, weight, operation time, postoperative recovery time, and endotraeheal extubation time. Ramsay score and M-Aldrete score immediately and 30 rain after extubation were recorded. The postoperative pain scores of all patients were recorded at the time point of 30 min, 1, 6 h and 24 h after endotracheal extubation by numerical rating scale （NRS）. Postoperative incidence of nausea and vomiting and other side effects were recorded. Results General characteristics of patients in both groups were similiar（P〉0.05）. Compared with group C [（3.5±1.6）, （3.7±1.5）, （3.4±1.8）, （2.4±1.4）], the NRS in group D[（1.4±1.3）, （1.7±1.5）, （1.5±1.5）, （0.9±0.8）] was significantly lower at 30 rain and 1 h after endotracheal extubation and 6, 24 h after operation respectively （P〈0.05）. Difference between the two groups was not statistically significant at each time point in mean arterial pressure and heart rate （P〉0.05）. There was no significant difference of Ramsay score and M-Aldrete score in both groups. The incidence of postoperative nausea and vomiting was significantly higher in group C（P〈0.05 ）. There were no respiratory depression, mental disorders, extrapyramidal reactions and other side effects in the two groups. Conclusions Droperidol pretreatment provides a significant analgesic benefit and makes patients undergoing gynecologic laparoscopic surgery comfortable.

关 键 词：氟哌利多 术后镇痛 妇科腹腔镜手术 

分 类 号：R614[医药卫生—麻醉学]