两种非甾体类镇痛药复合不同剂量舒芬太尼用于妇科开腹术后镇痛衔接效果的临床比较  

Comparison of Different doses of sufentanil combined with two non-steroidal analgesics for postoperative analgesia of gynaecology laparotomy

作　　者：康凯[1] 王玥[1] 张春雷[1] 郑琳[1] 徐铭军[1] 

机构地区：[1]首都医科大学附属北京妇产医院麻醉科,100026

出　　处：《北京医学》2015年第7期654-657,共4页Beijing Medical Journal

摘　　要：目的 比较氟比洛芬酯和帕瑞昔布钠复合不同剂量舒芬太尼用于妇科手术后镇痛衔接的效果和不良反应。方法 择期全麻气管插管下行妇科开腹手术成年女性患者80例,随机分为：氟比洛芬酯（50mg）＋舒芬太尼（5μg）组（F1组）、氟比洛芬酯（50mg）＋舒芬太尼（10μg）组（F2组）、帕瑞昔布钠（40mg）＋舒芬太尼（5μg）组（P1组）及帕瑞昔布钠（40mg）＋舒芬太尼（10μg）组（P2组）,每组各20例。所有患者均采用常规麻醉诱导及术中维持,手术结束前10 min时按药物分组情况采用静脉缓慢推注,然后连接相同配方的静脉镇痛泵转入麻醉恢复室。记录手术结束时（T0）、拔管即刻（T1）、拔管后5 min（T2）及10min（T3）、2 h（T4）及4h（T5）及6h（T6）各时点的MAP和HR及自主呼吸恢复时间、睁眼时间、拔管时间,记录T2T6时的VAS疼痛评分、Ramsay镇静评分和Riker-SAS躁动评分。结果MAP和HR：P1组在T1、T2时点明显高于其余3组（P〈0.05）,其余各时点差异无统计学意义;F2、P2组自主呼吸恢复时间长于另2组（P〈0.05）,在睁眼时间、拔管时间上四组患者差异无统计学意义;P1组在T2时点VAS评分明显高于另3组（P〈0.05）,在T6时点F1组VAS评分高于另3组（P〈0.05）;F2、P2组Ramsay镇静评分在T3时点高于另2组（P〈0.05）。结论 非甾体类镇痛药复合小剂量舒芬太尼可完全用于术后静脉镇痛衔接,相比之下氟比洛芬酯起效迅速,而帕瑞昔布维持镇痛的时间更长。Objective To compare the post-operative analgesic effect and advcrsc reactions of flurbiprofen axetil and parecoxib sodium combined with different doses of sufentanil for gynecologic surgery. Methods Be marked, 80 adult female patients who received endotracheal intubation general anesthesia downlink procedure were randomly divided into the flurbiprofen axetil 50 mg ＋ 5 μg sufentanil group （Fl）, flurbiprofen axetil 50 mg ＋ 10 μg sufentanil group （F2） and parecoxib sodium 40 mg＋5 μg sufentanil group （P1）, parecoxib sodium 40 mg＋10 μg sufentanil group （P2）, 20 cases in each group. All patients were treated with general anesthesia induction and intraoperative maintenance, 10 rain before the end of surgery in the drug group, slow intravenous injection was conducted, then intravenous analgesia pump tube were connected and patients were transferred to the anesthesia recovery room. The the MAP and HR and spontaneous breathing recovery time, open time, extubation time, the T2 to T6 VAS pain score, Ramsay sedation scores and Riker- SAS agitation score were recorded at the following time points end of surgery （TO）, tube drawing immediate （T1）, 5 min after extubation （T2）, 10 min after extubation （T3）, 2 h after surgery （T4）, postoperative 4 h （T5）, postoperative 6 h （T6）. Results The MAP and HR at the T1 and T2 point of P1 group was significantly higher than that of the other three groups （P 〈 0.05）, and the rest there parameters had no statistical significant difference at each point; The F2, P2 spontaneous breathing recovery time was longer than the other two groups （P 〈 0.05）. The open time, extubation time of the four groups of patients was not statistically significantly different. The VAS score in T2 of the P1 group was obviously higher than that of the other three groups （P 〈 0.05）. At T6 point, F1 VAS score was higher than the other three groups （P 〈 0.05）; The F2 of P2 Ramsay sedation scores in T3 point was higher than the other two gro

关 键 词：非甾体类镇痛药 镇痛衔接 VAS疼痛评分 RAMSAY镇静评分 

分 类 号：R614[医药卫生—麻醉学]