舒芬太尼用于腹腔镜宫颈癌根治术后靶控输注镇痛的临床效果  

Clinical Effect of Sufentanil in TCI Analgesia after Laparoscopic Radical Hysteyectomy for Cervical Cancer

作　　者：李鹏 周伟 袁永群 LI Peng;ZHOU Wei;YUAN Ybng-qun(Department of Anesthesiology, Caidian People＇s Hos- pital of Wuhan, Wuhan 430100, Hubei, China;Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China)

机构地区：[1]湖北省武汉市蔡甸区人民医院麻醉科,武汉430100 [2]华中科技大学同济医学院附属同济医院妇产科,武汉430030

出　　处：《中国现代手术学杂志》2018年第1期77-80,共4页Chinese Journal of Modern Operative Surgery

基　　金：2015-2016年度湖北省卫生计生西医类一般项目(WJ2015MB003)

摘　　要：目的探讨舒芬太尼用于腹腔镜宫颈癌根治术后TCI镇痛的临床效果。方法选取2015年2月~2016年12月在我院行腹腔镜根治性子宫切除术的64例患者,随机分为观察组和对照组,每组32例,术后观察组和对照组患者分别采取TCI镇痛和自控镇痛两种方式进行术后镇痛。比较两组患者镇痛前、镇痛后1 h、4 h和8 h的血气分析结果,以及镇痛前和镇痛后1 h、6 h、12 h、24 h、48 h的镇痛效果和镇静效果,比较两组患者不良反应发生情况。结果在镇痛前以及镇痛后1 h、4 h和8 h,两组患者pH、Pa O2和Pa CO2三项血气指标均正常,且组间比较差异无统计学意义(P>0.05)。镇痛前两组患者VAS评分接近,差异无统计学意义(P>0.05),而镇痛后各时点观察组VAS评分均显著低于对照组,差异有统计学意义(P<0.05)。镇痛前和镇痛后48 h两组间Ramsay评分比较,差异无统计学意义(P>0.05),其余时间点比较观察组评分均显著低于对照组,差异有统计学意义(P<0.05)。镇痛后16 h内,观察组出现不良反应1例(3.13%),对照组6例(18.75%),两组患者不良反应发生率比较,差异有统计学意义(χ2=4.0100,P=0.0452)。结论舒芬太尼用于腹腔镜宫颈癌根治术后TCI镇痛的镇痛效果和镇静效果较好,安全性较高,可临床推广。Objective To study the clinical efficacy of sufentanil in target controlled infusion（TCI） analgesia after laparoscopic radical hysterectomy for cervical cancer. Methods From February 2015 to December 2016,a total of 64 patients with cervical cancer who performed laparoscopic radical hysterectomy in our hospital were selected and divided randomly into observation group and control group with 32 cases for each,and carried out TCI analgesia and patient-controlled analgesia respectively for analgesia after the operation. The blood gas analysis before and 1-,4-and 8 h after analgesia,and the analgesic effects and sedative effects before and 1-,6-,12,24,48 h after analgesia were compared between the two groups. The adverse reactions of the two groups were also compared. Results The pH,Pa O2 and Pa CO2 indexes were normal in both groups before and 1-,4 h and 8 h after analgesia,and there was no statistical difference between the two groups（P〈0.05）.The VAS scores were similar without statistical difference in both two groups before analgesia（P〈0.05）. But the VAS score was obviously lower in the observation group than that in the control group at different time point after the analgesia,and there was statistical differences between two groups（P〈0.05）. There was no statistical difference in the Ramsay score before analgesia and 48 h after analgesia between two groups（P〈0.05）,while significant statistical difference existed at other time points between two groups（P〈0.05）. The adverse reaction rate was 3. 13% of the observation group and 18. 75% of the control group,and there was statistical difference between two groups（χ2= 4. 0100,P = 0. 0452）. Conclusion The analgesic effect and sedative effect of sufentanil can achieve reliable effect in TCI analgesia after laparoscopic radical resection for cervical cancer,and it is worthy of being popularization.

关 键 词：舒芬太尼 术后镇痛 靶控输注 宫颈癌 腹腔镜检查 根治性子宫切除术 

分 类 号：R614[医药卫生—麻醉学] R737.33[医药卫生—外科学]