不同镇痛方案在急诊腹腔镜阑尾切除术后的观察研究  

Observation on the Efficacy of Different Analgesics after Emergency Laparoscopic Appendectomy

作　　者：赵子然 邹军[1] 杨淑婷 ZHAO Zi-ran;ZOU Jun;YANG Shu-ting(Department of Anesthesiology,Sun Yatsen Memorial Hospital of Sun Yatsen University,Guangzhou,510120)

机构地区：[1]中山大学孙逸仙纪念医院麻醉科,510120

出　　处：《岭南急诊医学杂志》2021年第6期590-592,共3页Lingnan Journal of Emergency Medicine

基　　金：广东省基础与应用基础研究基金(2020A1515010117)。

摘　　要：目的:探讨纳布啡方案的患者自控静脉镇痛在急诊腹腔镜阑尾切除术后的效果。方法:选取明确诊断急性阑尾炎行腹腔镜阑尾切除术的82例患者,将其随机分为观察组(纳布啡组)和对照组(舒芬太尼组)每组41例。观察比较两组患者术后自主呼吸恢复时间、拔管时间、术后有无追加镇痛、有无恶心呕吐、24小时患者自控静脉镇痛(patient⁃controlled intravenous analgesia,PCIA)有效按压次数、24小时静态疼痛视觉模拟评分法(visual analogue scale,VAS)评分、24小时动态疼痛VAS评分、24小时恶心呕吐头晕等不良反应发生率。结果:两组患者术后自主呼吸恢复时间、拔管时间、术后有无追加镇痛、有无恶心呕吐无明显差异(P>0.05)。观察组患者24小时PCIA有效按压次数、24小时静态疼痛、24小时动态疼痛、24小时恶心呕吐情况均优于对照组(P<0.05)。结论:纳布啡用于急诊腹腔镜阑尾炎切除术患者的术后镇痛有良好的镇痛效果且有效减少术后镇痛追加的次数,减少恶心呕吐的发生率。Objective:To evaluate the efficacy of nabulphine in patient undergoing emergency laparoscopic appendectomy and patient⁃controlled intravenous analgesia.Methods:A total of 82 patients undergoing emergency laparoscopic appendectomy with a definite diagnosis of acute appendicitis were randomly divided into an observation group(nabulphine as analgesic)and a control group(sufentanil as analgesic),with 41 cases in each group.The recovery time of spontaneous respiration,extubation time,the use of additional analgesics after the operation,complications(nausea and vomiting)or not after the operation,the effective PCIA pressing times during 24 hours,the static VAS scores at 24 h,the active VAS scores at 24 h,complications or not at 24h are compared between two groups.Results:The recovery time of spontaneous respiration,extubation time,the use of additional analgesics after the operation and complications(nausea and vomiting)after the operation are no difference between two groups.The effective PCIA pressing times during 24 hours,the static VAS scores at 24 h,the active VAS scores at 24 h,complications at 24 h were significantly lower in the observation group than in the control group(P<0.05).Conclusion:Nabulphine can yield satisfactory analgesic effect for patients after emergency laparoscopic appendectomy and decrease the effective PCIA pressing times during 24 hours and incidence of complications.

关 键 词：急诊腹腔镜阑尾切除术 纳布啡 患者自控静脉镇痛 

分 类 号：R614[医药卫生—麻醉学]