达芬奇机器人心脏外科术后应用芬太尼透皮贴镇痛对切口疼痛的影响  

Effect of fentanyl transdermal patch analgesia on incision pain after Da Vinci robot-assisted cardiac surgery

作　　者：孙君辉[1] 何萌[1] 谷静媛 曹学静 Sun Junhui;He Meng;Gu Jingyuan;Cao Xuejing(Department of Cardiac Surgery,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院心脏外科,100029

出　　处：《中国医药》2020年第2期191-194,共4页China Medicine

摘　　要：目的观察达芬奇机器人心脏手术后使用芬太尼透皮贴对术后切口疼痛的影响。方法选取2016年12月至2018年12月在首都医科大学附属北京安贞医院心脏外科进行达芬奇机器人心脏手术的成人患者88例。通过随机数字表法分为观察组和对照组,每组44例。术后第2天开始,对照组术后使用安慰剂贴剂,观察组使用芬太尼透皮贴缓解手术切口疼痛,应用贴片12 h/d,直到感觉不需要镇痛,最长使用至术后30 d。围术期采用疼痛视觉模拟量表(VAS)进行评估,并通过门诊和电话随访,对比各个时间点(术前及术后第2、7、30、90、180天)患者疼痛评分。结果2组患者术前基线及术后第2天VAS评分差异均无统计学意义(均P>0.05)。术后第7、30、90天,观察组VAS评分明显低于对照组[(3.1±1.7)分比(5.1±1.9)分、(1.9±0.7)分比(3.2±1.7)分、(1.2±0.4)分比(2.1±0.9)分],差异均有统计学意义(均P<0.05)。术后第180天,2组VAS评分差异无统计学意义(P>0.05)。结论达芬奇机器人心脏手术后使用芬太尼透皮贴能够有效减轻术后切口疼痛。Objective To observe the effect of fentanyl transdermal patch on incision pain after Da Vinci robot-assisted cardiac surgery.Methods A total of 88 adult patients undergoing Da Vinci robot-assisted cardiac surgery in Beijing Anzhen Hospital,Capital Medical University from August 2016 to August 2018 were randomly divided into observation group and control group,with 44 cases in each group.After surgery,the observation group used fentanyl transdermal patch and the control group used placebo patch around incision,once every 12 hours until pain disappeared,or for 30 days.Perioperative pain was assessed by Visual Analogue Scale(VAS)before surgery and on the 2nd,7th,30th,90th and 180th days after surgery.Results There were no significant differences in VAS scores before and on the 2nd day after surgery between groups(both P>0.05).VAS scores on the 7th,30th,90th days with fentanyl transdermal patch were lower than those with placebo[(3.1±1.7)vs(5.1±1.9),(1.9±0.7)vs(3.2±1.7),(1.2±0.4)vs(2.1±0.9)](all P<0.05).On the 180 th day after surgery,VAS score showed no significant difference between groups(P>0.05).Conclusion Fentanyl transdermal patch can effectively alleviate acute incision pain after robot-assisted cardiac surgery.

关 键 词：心脏手术 达芬奇机器人 芬太尼透皮贴 术后镇痛 

分 类 号：R654.2[医药卫生—外科学]