舒芬太尼静脉自控镇痛对宫颈癌术后患者疼痛及应激反应的影响  

Effect of sufentanil patient⁃controlled intravenous analgesia on postoperative pain and stress response in patients with cervical cancer

作　　者：孟明华 邹长玲 吕慎娟 李慧敏 李震 MENG Minghua;ZOU Changling;LV Shenjuan;LI Huimin;LI Zhen(Department of Anesthesiology,Jinan Second Maternal and Child Health Hospital,Jinan,Shandong,China,271199;Department of Anesthesiology,Gangcheng District People's Hospital,Jinan,Shandong,China,271104)

机构地区：[1]济南市第二妇幼保健院麻醉科,山东济南271199 [2]济南市钢城区人民医院麻醉科,山东济南271104

出　　处：《分子诊断与治疗杂志》2023年第7期1225-1228,1233,共5页Journal of Molecular Diagnostics and Therapy

基　　金：济南市科技计划项目(202012385)。

摘　　要：目的探讨舒芬太尼静脉自控镇痛对宫颈癌术后患者疼痛及应激反应的影响。方法选取2020年2月至2022年3月济南市第二妇幼保健院共102例宫颈癌手术患者为研究对象,根据不同麻醉药物分成两组,对照组予地佐辛,研究组予舒芬太尼,均行静脉自控镇痛,比较围术期两组应激反应和炎症因子,疼痛评分,不良反应和镇痛按压次数、抑郁评分变化。结果麻醉前两组应激指标去甲肾上腺素(NE)、肾上腺素(E)、皮质醇(Cor)和炎症因子C反应蛋白(CRP)、肿瘤坏死因子⁃α(TNF⁃α)含量比较差异无统计学意义(P>0.05),术后舒芬太尼组2、6、12、24h指标含量均较同时间段地佐辛组低,差异有统计学意义(P<0.05)。麻醉前和术后2、6、12、24 h两组NRS评分比较差异无统计学意义(P>0.05);麻醉前两组VAS评分比较差异无统计学意义(P>0.05),术后舒芬太尼组6、12、24 h VAS评分均较同时间段地佐辛组低,差异有统计学意义(t=0.971、4.205、14.446、15.345,P<0.05)。舒芬太尼组不良反应发生率显著低于地佐辛组,差异有统计学意义(χ^(2)=4.320,P<0.05),舒芬太尼组镇痛按压次数、抑郁评分显著低于地佐辛组,差异有统计学意义(t=9.579、10.164,P<0.05)。结论舒芬太尼静脉自控镇痛能缓解宫颈癌术后患者疼痛程度,降低机体应激反应,这可能和该药物能抑制炎症反应有关,且不良反应轻。Objective To investigate the effect of sufentanil patient⁃controlled intravenous analge⁃sia on postoperative pain and stress response in patients with cervical cancer.Methods 102 patients with cer⁃vical cancer surgery from February 2020 to March 2022 in Jinan Second Maternal and Child Health Hospital were selected and divided into two groups according to different anesthetic drugs.The control group was given dezocine,and the study group was given sufentanil.and the stress response and inflammatory factors,pain score,the changes of adverse reactions,times of analgesia and depression scores were compared between the two groups.Results there was no significant difference in the contents of norepinephrine(NE),epinephrine(E),cortisol(COR),inflammatory factor C⁃reactive protein(CRP)and tumor necrosis factor⁃α(TNF⁃α)between the two groups before anesthesia(P>0.05),and the index content of sufentanil group was lower than that of dezocine group at 2 h,6 h,12 h and 24 h after operation,and the difference was statistically signifi⁃cant(P<0.05).There was no significant difference in NRS scores between the two groups before anesthesia and at 2 h,6 h,12 h and 24 h after operation(P>0.05),there was no significant difference in VAS scores be⁃tween the two groups before anesthesia(P>0.05),but the VAS score of sufentanil group was lower than that of dezocine group at 6 h,12 h and 24 h after operation,the difference was statistically significant(t=0.971,4.205,14.446,15.345,P<0.05).The incidence of adverse reactions in the sufentanil group was significantly lower than that in the dezocine group(χ^(2)=4.320,P<0.05),and the times of analgesia and depression score in the sufentanil group were significantly lower than those in the dezocine group(t=9.579,10.164,P<0.05).Conclusion Patient controlled intravenous analgesia with sufentanil can relieve pain and reduce the stress re⁃action in patients with cervical cancer after operation,which may be related to the inhibition of inflammatory reaction and mild adverse react

关 键 词：舒芬太尼 静脉自控镇痛 宫颈癌术后 疼痛数字评分 应激反应 炎症因子 疼痛视觉模拟评分 

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