舒芬太尼用于腹腔镜宫颈癌根治术后靶控镇痛的临床研究  

Clinical research of postoperative analgesia with target- controlled infusion of sufentanil after laparoscopic cervical cancer surgery

作　　者：彭丹晖[1] 韦程瀚[1] 黄薇[1] 黄冰[1] 黎阳[2] 

机构地区：[1]广西医科大学附属肿瘤医院麻醉科,南宁530021 [2]广西医科大学附属肿瘤医院重症医学科,南宁530021

出　　处：《中国临床药理学杂志》2016年第9期774-777,共4页The Chinese Journal of Clinical Pharmacology

基　　金：广西医疗卫生适宜技术研究与开发课题基金资助项目(S201301-04)

摘　　要：目的观察舒芬太尼用于腹腔镜宫颈癌根治术后靶控输注(TCI)镇痛的临床疗效及安全性。方法美国麻醉医师协会麻醉分级Ⅰ~Ⅱ级择期进行腹腔镜宫颈癌根治术的患者36例随机分2组。试验组(靶控镇痛)18例,给予舒芬太尼初始血浆靶浓度0.1 ng·mL^(-1),疼痛时上调靶浓度0.01 ng·mL^(-1),锁定15min。对照组(患者自控镇痛)18例,给予舒芬太尼背景剂量3μg·h^(-1),患者静脉自控镇痛冲击剂量每次3μg,锁定15 min。于镇痛前(T_0)及镇痛后0.5(T_1),1(T_2),1.5(T_3),2(T_4),4(T_5),8(T_6),12(T_7)和16 h(T_8),记录生命体征、Prince-Henry评分、Ramsay评分、舒芬太尼术后镇痛总剂量、患者自主要求镇痛次数和不良反应发生情况,并在T_0、T_2、T_5、T_6进行血气分析。TIVAtrainer软件拟合计算舒芬太尼药代动力学曲线。结果 2组平均动脉压、心率、呼吸频率、脉搏血氧饱和度和血气指标均在正常范围内。试验组在T_1、T_2、T_3、T_6、T_7、T_8时Prince-Henry评分显著低于对照组(P<0.05),2组Ramsay评分差异无统计学意义(P>0.05)。对照组自主镇痛次数多于试验组。试验组血浆靶浓度在T_1、T_5、T_6、T_7、T_8显著高于对照组(P<0.05)。2组不良反应发生率差异无统计学意义(P>0.05)。结论舒芬太尼血浆靶浓度0.1 ng·mL^(-1)行术后靶控镇痛,与患者静脉自控镇痛比较,镇痛疗效更佳且不增加不良反应发生率。Objective To investigate the efficacy and safety of postoperative analgesia with target-controlled infusion（TCI） of sufentanil after laparoscopic cervical cancer surgery. Methods Thirty six patients with American society anesthesiologists（ASA） Ⅰ- Ⅱ undergoing elective laparoscopic radical resection of cervical cancer were randomly divided into two groups： treatment group（ target controlled infusion,18 cases）and control group（ patient controlled intravenous analgesia,18 cases）.In treatment group,the target plasma concentration of sufentanil was set at 0. 1 ng·mL^-1. In control group,the rate was 3 μg·h^-1,bolus of 3μg with lockout interval 15 min. Mean artery pressure（ MAP）,heart rate（ HR）,respiratory frequency（ RR） and pulse oxygen saturation（SpO2） were monitored during postoperative analgesia. The Prince-Henry pain score,Ramsay sedation score,sufentanil dosage and the number of press,arterial blood gas,sufentanil target plasma concentration,and the incidence of adverse reactions were recorded and comparedin two groups before analgesia（ T0） and 0. 5（ T1）,1（ T2）,1. 5（ T3）,2（ T4）,4（ T5）,8（ T6）,12（ T7） and 16 h（ T8） after analgesia. Results There was no significant difference of MAP,HR,RR,SpO2 and artery blood gas between two groups. Prince-Henry score in treatment group at T1,T2,T3,T6,T7,T8 were lower compared to control group（P〈0. 05）. There was no significant difference in Ramsay score between the two groups（ P〈0. 05）. The total amount of sufentanil and the number of non-press in treatment group was higher than that of control group. There was statistically significant about target plasma concentration between two groups at T1,T5,T6,T7,T8. The target concentration fluctuations in treatment group smaller than in control group（ P〈0. 05）. There was no significant difference in adverse reactions between two groups（ P〉0. 05）. Conclusion Target controlled infusion of sufentanil for postoperative analgesia analgesia sho

关 键 词：舒芬太尼 术后镇痛 患者静脉自控镇痛 靶控输注 

分 类 号：R971.2[医药卫生—药品]