不同类型止痛药对妇科腹腔镜手术术后肠麻痹的影响  

Effect of different types of analgesic on postoperative enteroparalysis after gynecological laparoscopic surgery

作　　者：杨艳峰 刘洪涛[1] YANG Yan-feng;LIU Hong-tao(Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang 110004, China)

机构地区：[1]中国医科大学附属盛京医院麻醉科,沈阳110004

出　　处：《实用药物与临床》2018年第4期415-418,共4页Practical Pharmacy and Clinical Remedies

摘　　要：目的观察3种不同类型的静脉止痛药对妇科腹腔镜手术术后肠麻痹的影响。方法选取全身麻醉下行腹腔镜子宫肌瘤剔除术患者75例,ASAⅠ~Ⅱ级。随机分为舒芬太尼组(S组)、酮咯酸氨丁三醇组(N组)与布托啡诺组(B组),每组25例。麻醉诱导及维持采取相同方案,于术毕前给予各组对应药物作为负荷量并接PCIA静脉镇痛泵。记录三组患者停药至拔管时间,不同时刻VAS评分与Ramsay镇静评分,首次肠鸣音恢复及肛门排气时间,不良反应发生率。结果三组患者对应时点的VAS评分差异无统计学意义(P>0.05)。N组、S组拔管时间较B组缩短,镇静评分较低(P<0.05)。N组患者术后首次肠鸣音恢复、肛门排气时间较B组、S组缩短,且不良反应发生率低于B组、S组(P<0.05)。结论行腹腔镜下子宫肌瘤剔除术患者,应用酮咯酸氨丁三醇联合雷莫司琼进行镇痛,效果理想,并能缩短术后肠麻痹的持续时间,不良反应发生率较低。Objective To observe the effects of three different types of analgesics on postoperative enteropa- ralysis after gynecological laparoscopic surgery. Methods A total of 75 cases scheduled for laparoscopic myomecto- my, with ASAⅠ～Ⅱ , were randomly divided into sufentanil group （group S ） , ketorolac tromethamine group （group N） and butorphanol group （group B ） ,25 in each group. All the patients received the same induction and maintenance of anesthesia. Each group was given a load dose of corresponding drug and PCIA pump was connected till the end of surgery. The time from drug withdrawal to extubation, VAS and Ramsay sedation scores at different time points, the time of recovery of bowel sound and anus exhaustion and the incidence of adverse effects were recorded. Results There was no significant difference in VAS scores among the 3 groups （ P 〉 0. 05 ）. The time of extubation in group N and group S was less than that of group B （P 〈 0. 05 ） ,and the sedation scores were lower （ P 〈 0. 05 ）. The time of re- covery of bowel sound and anus exhaustion in group N was less than that of group B and group S （P 〈0. 05） ,and the incidence of adverse effects was lower （P 〈 0. 05）. Conclusion Ketorolac tromethamine is suitable for relieving post- operative pain in patients undergoing laparoscopic myomectomy, and it can shorten the duration of postoperative entero- paralysis with fewer adverse effects.

关 键 词：布托啡诺 舒芬太尼 酮咯酸氨丁三醇 胃肠功能障碍 

分 类 号：R614[医药卫生—麻醉学]