等效镇痛剂量芬太尼、瑞芬太尼和舒芬太尼对维吾尔族患者镇静及副作用影响的对比研究  

Comparison of the effects produced by equivalent analgesic doses of fentanyl,remifentanil and sufentanil on vital signs in Uigur patients

作　　者：崔士和[1] 蒋忠[1] 

机构地区：[1]南京大学医学院附属鼓楼医院麻醉科,江苏南京210008

出　　处：《现代医学》2016年第2期187-190,共4页Modern Medical Journal

摘　　要：目的:比较等效镇痛剂量芬太尼、瑞芬太尼和舒芬太尼对维吾尔族患者镇静时生命体征的影响。方法:选择新疆伊宁市人民医院80例拟择期行气管插管全麻下手术的患者,采用数字表法随机分为对照组(D组)、芬太尼组(F组)、瑞芬太尼组(R组)、舒芬太尼组(S组)4组各20例。F、R、S组静脉30 s内分别给予芬太尼2μg·kg^(-1)、瑞芬太尼2μg·kg^(-1)、舒芬太尼0.2μg·kg^(-1),D组给予等容量生理盐水10 ml。观察给药前(T0)及给药后1 min(T1)、3 min(T2)、5 min(T3)、10 min(T4)5个时间点患者生命体征及不良反应发生情况。结果:与D组比较,Ramsay评分F、R组在T2~T3、S组在T2~T4存在明显差异;与F、R组比较,S组在T4显著降低。与D组比较,F、R组呼吸频率在T2~T3、S组在T2~T4存在明显差异(P<0.05)。心率R组在T2~T3较D组有明显差异。不良反应:3个实验组间F组恶心呕吐、R组心率<50次·min^(-1)、S组呼吸抑制的发生率分别较其余两组明显增加。结论:上述3种等效镇痛剂量阿片类药物用于维吾尔族患者镇静时,芬太尼恶心呕吐的发生率较高,瑞芬太尼对患者心率的影响较大,舒芬太尼对意识、呼吸的抑制作用最明显。Objective： To examine the different effects produced by equivalent analgesic doses of fentanyl,remifentanil and sufentanilin on vital signs in Uigur patients. Methods： Eighty patients undergoing selective operation in Yining hospital of Xinjiang Uygur Autonomous Region were randomly assigned into four groups with 20 in each group： control group（ group D）; group remifentanil（ group R）; group sufentanil（ group S） and group fentanyl（ group F）. Remifentanil 2 μg·kg^-1,sufentanil 0. 2 μg·kg^-1and fentanyl 2 μg·kg^-1in normal saline10 ml were infused intravenously over 30 s in group R,S and F respectively. MAP,HR,SPO_2,RR and the score of Ramsay were recorded before（ T0）,and 1（ T1）,3（ T2）,5（ T3） and 10（ T4） min. Besides,the incidences of bucking,pruritus,muscle rigidity,nausea and vomiting,respiratory depression（ Sp O_2 〈90% or RR ≤ 8 sub per minute）,MAP〈 65 mm Hg,and HR 〈50 sub per minute were also monitored. Results： Ramsay score： Compared with group D,the scores in group F,R at T2,T3 and group S at T2,T4 declined significantly,so did the scores in group S at T4 compared with group F and R. Respiratory： RRs in group F,R were lower than those in group D at T2,T3,but they were the same as those in group S at T2,T4. Circulation： HR in group R was apparently lower than that in group D at T2,T4. Side reactions： Severe nausea and vomiting,highest HR decrease and prominent respiratory depression were respectively caused by fentanyl,remifentanil and sufentanil. Conclusion： Fentanyl can cause the highest incidence of nausea and vomiting,remifentanil has the greatest impact on HR and sufentanil generates prominent inhibitory effects on consciousness and respiratory.

关 键 词：镇痛药 阿片类 生命体征 维吾尔族 不良反应 

分 类 号：R971[医药卫生—药品]