不同镇痛药物对术后苏醒期躁动的影响  

Effect of different analgesics on postoperative agitation and shivering in tumor patients after general anesthesia

作　　者：韩斌[1] 徐铭军[1] 张明[1] 

机构地区：[1]首都医科大学附属北京妇产医院麻醉科,100006

出　　处：《北京医学》2016年第11期1164-1166,共3页Beijing Medical Journal

摘　　要：目的比较舒芬太尼和帕瑞昔布对预防妇科肿瘤患者全麻苏醒期躁动的影响。方法选取2015年12月至2016年3月在我院全麻下行择期腹腔镜宫颈癌或子宫内膜癌手术的患者91例,ASAⅠ或Ⅱ级,随机分为舒芬太尼组45例(SF组),帕瑞昔布组46例(P组)。所有患者均采用全凭静脉麻醉,采用血浆靶控输注丙泊酚和瑞芬太尼进行麻醉诱导与维持,手术结束前10 min,SF组静脉推注舒芬太尼0.2μg/kg,P组静脉推注帕瑞昔布40 mg。记录患者苏醒期的生命体征,疼痛评分,术毕至拔除气管导管时间;拔除气管导管后1 h评估苏醒期的镇静评分和躁动分级;记录患者恶心、呕吐等不良反应情况。结果术毕时P组MAP与SF组比较,差异有统计学意义(P<0.05);拔管后30 min P组VAS评分与SF组比较,差异有统计学意义(P<0.01),P组患者拔管时间与SF组比较,差异有统计学意义(P<0.01)。结论帕瑞昔布是预防苏醒期躁动安全有效的药物,舒芬太尼镇痛效果较好,但可能会导致患者苏醒期延长。Objective To compare the effect of different analgesics on postoperative agitation in tumor patients after general anesthesia. Methods The study included 91 female patients who received laparoscopic surgery for cervical cancer or endometrial cancer between December 2015 and March 2016 in Beijing Obstetrics and Gynecology Hospital. They were randomly divided into the sufentanil group（SF group, 45 cases）, the parecoxib group（P group, 46 cases）. All patients were treated with total intravenous anesthesia, using conventional methods for anesthesia induction and maintenance. Before the end of operation, Group SF received sufentanil 0.2 μg/kg,Group P received parecoxib 40 mg. The occurrence of agitation was observed during waking up period in PACU.The patient＇s vital signs, VAS pain scores, extubation time, Ramsay sedation scores, Riker-SAS agitation scores were recorded. Results MAP at T1 of Group P was statistically significantly different when compared with Group SF（P〈0.05）. The VAS at T3 of Group P was statistically significantly different when compared with Group SF（P〈0.01）. The extubation time of was significantly different from Group SF（P〈0.01）. Conclusion Parecoxib is safe and effective for postoperative agitation.

关 键 词：舒芬太尼 帕瑞昔布 苏醒期 躁动 

分 类 号：R614[医药卫生—麻醉学]