舒芬太尼联合布托啡诺与舒芬太尼联合地佐辛用于单孔胸腔镜肺叶切除术后镇痛的效果比较  

Efficacy comparison between sufentanil combined with butorphanol and sufentanil combined with dezocine for postoperative analgesia of single‐port thoracoscopic lobectomy

作　　者：牛静[1] 康金秀[2] 刘娜 Niu Jing;Kang Jinxiu;Liu Na(Department of Anesthesiology,Shanxi Province Cancer Hospital,Shanxi Hospital Affiliated to Cancer Hospital,Chinese Academy of Medical Sciences,Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan 030013,China;Department of Hospice Unit,Shanxi Province Cancer Hospital,Shanxi Hospital Affiliated to Cancer Hospital,Chinese Academy of Medical Sciences,Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan 030013,China)

机构地区：[1]山西省肿瘤医院、中国医学科学院肿瘤医院山西医院、山西医科大学附属肿瘤医院麻醉科,太原030013 [2]山西省肿瘤医院、中国医学科学院肿瘤医院山西医院、山西医科大学附属肿瘤医院宁养院,太原030013

出　　处：《肿瘤研究与临床》2024年第6期454-458,共5页Cancer Research and Clinic

摘　　要：目的探讨舒芬太尼联合布托啡诺与联合地佐辛用于单孔胸腔镜肺叶切除术后镇痛的效果。方法前瞻性随机对照研究。前瞻性选取2023年10月至12月山西省肿瘤医院行单孔胸腔镜肺叶切除手术患者72例,按随机数字表法分为A组和B组,每组36例。A组采用舒芬太尼联合地佐辛进行术后镇痛;B组采用舒芬太尼联合布托啡诺进行术后镇痛。比较两组术后不同时间点疼痛视觉模拟(VAS)评分、Ramasy镇静评分、生命体征监测指标、术后不良反应和拔除胸腔闭式引流管的时间。结果A组男性20例(55.6%),女性16例(44.4%),年龄(58±10)岁;B组男性16例(44.4%),女性20例(55.6%),年龄(56±11)岁;两组性别、年龄、体质量质数、美国麻醉医师协会分级、手术时间差异均无统计学意义(均P>0.05)。两组术后2、6、10 h的VAS评分比较,差异均无统计学意义(均P>0.05);12、24、48 h B组VAS评分均低于A组,差异均有统计学意义(均P<0.01)。B组患者术后2、6、10、12、24、48 h的Ramasy评分均高于A组,差异均有统计学意义(均P<0.05)。A组术后拔除胸腔引流管时间为(4.5±1.7)d,长于B组的(3.7±0.8)d,差异有统计学意义(t=2.58,P=0.014)。两组患者术后2、6、10、12、24、48 h的收缩压、舒张压、血氧饱和度、心率、呼吸情况比较,差异均无统计学意义(均P>0.05)。两组患者术后不良反应发生率均为16.67%(6/36)。结论舒芬太尼联合布托啡诺用于单孔胸腔镜肺叶切除术后镇痛效果较舒芬太尼联合地佐辛好,可能有助于加速患者术后康复。Objective To investigate the efficacy of sufentanil combined with butorphanol and sufentanil combined with dezocine for postoperative analgesia of single-port thoracoscopic lobectomy.Methods A prospective randomized controlled study was conducted.A total of 72 patients who underwent single-port thoracoscopic lobectomy in Shanxi Province Cancer Hospital from October to December 2023 were prospectively selected,and the patients were divided into group A and group B according to randomized numerical table method,with 36 cases in each group.Group A used sufentanil combined with dezocine for postoperative analgesia;group B used sufentanil combined with butorphanol for postoperative analgesia.The visual analogue scale(VAS)scores of pain,Ramasy sedation scores,vital signs monitoring indexes,postoperative adverse reactions,and the time of removing the closed chest drain were compared between the two groups at different time points in the postoperative period.Results There were 20 males(55.6%)and 16 females(44.4%)in group A,aged(58±10)years old;there were 16 males(44.4%)and 20 females(55.6%)in group B,aged(56±11)years old;there were no statistically significant differences between the two groups in terms of gender,age,body mass index,American Society of Anesthesiologists classification,and surgery time(all P>0.05).Comparison of the VAS scores of the two groups at 2,6 and 10 h after surgery showed no statistically significant differences(all P>0.05);the VAS scores of group B at 12,24 and 48 h were lower than those of group A,and the differences were statistically significant(all P<0.01).The Ramasy scores of the patients in group B at 2,6,10,12,24,and 48 h after surgery were higher than those of group A,and the differences were statistically significant(all P<0.05).The postoperative chest drain removal time in group A was(4.5±1.7)d,which was longer than that in group B[(3.7±0.8)d],and the difference was statistically significant(t=2.58,P=0.014).Comparison of systolic blood pressure,diastolic blood pressure,oxygen satura

关 键 词：胸腔镜 外科手术 镇痛 布托啡诺 地佐辛 舒芬太尼 

分 类 号：R614[医药卫生—麻醉学]