妇科腹腔镜手术麻醉不同剂量舒芬太尼应用情况研究分析
|
摘要
目的研究分析妇科腹腔镜手术麻醉不同剂量舒芬太尼应用情况。方法 127例采用腹腔镜手术治疗的患者,根据舒芬太尼麻醉剂量不同分为A组(64例)和B组(63例)。A组舒芬太尼剂量为0.3 mg/L, B组舒芬太尼剂量为0.5 mg/L。比较两组患者术后不同时间段疼痛评分、镇痛泵药物使用剂量、自主呼吸时间、拔管时间以及术后不良反应发生比较。结果 B组患者术后2、4、12 h疼痛评分均低于A组,差异具有统计学意义(P<0.05)。A组患者不良反应发生率为7.81%,低于B组的20.63%,差异具有统计学意义(P<0.05)。A组患者自主呼吸时间、拔管时间均短于B组,但差异具有统计学意义(P>0.05)。A组术后2 h镇痛泵药物使用剂量为(10.08±0.75)ml,术后4 h为(21.01±1.02)ml,术后12 h为(55.97±5.18)ml;B组术后2 h镇痛泵药物使用剂量为(9.03±0.26)ml,术后4 h为(17.86±0.74)ml,术后12 h为(47.19±4.63)ml;B组患者术后2、4、12 h镇痛泵药物使用剂量均低于A组,差异具有统计学意义(P<0.05)。结论妇科腹腔镜手术麻醉舒芬太尼剂量的增加使镇痛效果明显提高,术后镇痛泵药物使用剂量较低,但是术后不良反应发生率也随之增加,所以临床舒芬太尼剂量使用应根据患者的实际情况进行剂量的选择。
Objective To study and analyze the application of different doses of sufentanil in gynecological laparoscopic surgery. Methods A total of 127 patients treated with laparoscopic surgery were divided by different doses of sufentanil into group A(64 cases) and group B(63 cases). Group A was treated with 0.3 mg/L of sufentanil, and group B was treated with 0.5 mg/L of sufentanil. Comparison were made on pain scores at different time points after operation analgesic pump dosage, spontaneous breathing time and extubation time and occurrence of postoperative adverse reactions between the two groups. Results Group B had lower pain score at 2, 4 and 12 h after operation than group A, and the difference was statistically significant(P<0.05). Group A had lower incidence of adverse reactions as 7.81% than 20.63% in group B, and the difference was statistically significant(P<0.05). Group A had shorter spontaneous breathing time and extubation time than group B, but the difference was not statistically significant(P>0.05). Group A had dosage of analgesic pump as(10.08±0.75) ml at 2 h after operation,(21.01±1.02) ml at 4 h after operation and(55.97±5.18) ml at 12 h after operation, which were(9.03±0.26),(17.86±0.74) and(47.19±4.63) ml in group B. Group B had less dosage of analgesic pump at 2, 4 and 12 h after operation than group A, and the difference was statistically significant(P<0.05). Conclusion The increase of sufentanil dosage in gynecological laparoscopic surgery can significantly improve the analgesic effect and lower the dosage of analgesic pump after operation. However, the incidence of adverse reactions after operation also increased, so the clinical dosage of sufentanil should be selected according to the actual situation of patients.
Objective To study and analyze the application of different doses of sufentanil in gynecological laparoscopic surgery. Methods A total of 127 patients treated with laparoscopic surgery were divided by different doses of sufentanil into group A(64 cases) and group B(63 cases). Group A was treated with 0.3 mg/L of sufentanil, and group B was treated with 0.5 mg/L of sufentanil. Comparison were made on pain scores at different time points after operation analgesic pump dosage, spontaneous breathing time and extubation time and occurrence of postoperative adverse reactions between the two groups. Results Group B had lower pain score at 2, 4 and 12 h after operation than group A, and the difference was statistically significant(P<0.05). Group A had lower incidence of adverse reactions as 7.81% than 20.63% in group B, and the difference was statistically significant(P<0.05). Group A had shorter spontaneous breathing time and extubation time than group B, but the difference was not statistically significant(P>0.05). Group A had dosage of analgesic pump as(10.08±0.75) ml at 2 h after operation,(21.01±1.02) ml at 4 h after operation and(55.97±5.18) ml at 12 h after operation, which were(9.03±0.26),(17.86±0.74) and(47.19±4.63) ml in group B. Group B had less dosage of analgesic pump at 2, 4 and 12 h after operation than group A, and the difference was statistically significant(P<0.05). Conclusion The increase of sufentanil dosage in gynecological laparoscopic surgery can significantly improve the analgesic effect and lower the dosage of analgesic pump after operation. However, the incidence of adverse reactions after operation also increased, so the clinical dosage of sufentanil should be selected according to the actual situation of patients.
引文
[1]朱俊强,施伟民,殷国华.喷他佐辛复合舒芬太尼在妇科腹腔镜手术中的应用价值.实用药物与临床,2014,17(3):295-297.
[2]张仲金.舒芬太尼复合丙泊酚麻醉在妇科腹腔镜手术中的临床效果观察.中国初级卫生保健,2015,29(2):48-50.
[3]刘娜,邵贵骞,刘艳,等.不同剂量盐酸戊乙奎醚对腹腔镜妇科手术患者呼吸力学的影响.医学研究杂志,2014,43(10):81-85.
[4]彭文平,王巧恒,左明章.复合异丙酚时舒芬太尼抑制双腔支气管导管插管反应的半数有效剂量.中华麻醉学杂志,2015,35(12):1470-1472.
[5]徐嘉莹,桑诺尔,任丽英,等.不同舒芬太尼配置浓度对术后患者静脉自控镇痛效果和不良反应的影响.中国医学科学院学报,2017,39(3):406-410.
[6]史辛波,郑戈,徐佳,等.瑞芬太尼、舒芬太尼全凭静脉麻醉在妇科腹腔镜手术中的应用.局解手术学杂志,2015(1):52-55.
[7]朱云峰,彭丽,幸吉娟,等.三种剂量舒芬太尼用于患儿腹腔镜手术的麻醉效果.临床麻醉学杂志,2012,28(9):878-881.
[8]孟元光.腹腔镜在妇科领域的应用.腹腔镜外科杂志,2012,17(5):395-397.
[9]何亮亮,李炜,陈明慧,等.不同靶控浓度舒芬太尼在全麻诱导气管插管中对血流动力学的影响.临床麻醉学杂志,2008,24(1):29-31.
[10]黎海平,石少梅,李宇,等.不同剂量舒芬太尼应用于妇科腹腔镜手术麻醉中的临床效果.蛇志,2017,29(1):14-16.
[11]黎海平,石少梅,李宇,等.舒芬太尼在妇科腹腔镜手术麻醉中的应用进展.医学综述,2017,23(7):1388-1392.
[12]宋斌,蒋晧宇,闫鑫,等.靶控输注舒芬太尼或瑞芬太尼用于妇科腹腔镜手术麻醉的临床研究.新疆医科大学学报,2017,40(6):751-754.
[13]樊素雄,李春涛.妇科腹腔镜手术老年患者应用舒芬太尼复合异丙酚麻醉的应用疗效.临床医药文献电子杂志,2016,3(14):2850-2851.
[14]陈玉,张文强,邱小凤.宫腔镜手术中应用舒芬太尼与瑞芬太尼复合丙泊酚麻醉的效果对比.中外医疗,2016,35(20):121-123.
[15]杨立军,哈春芳.不同麻醉药在妇科腹腔镜手术中镇痛效果的临床观察.宁夏医学杂志,2017,39(9):830-832.
[16]曹玲.舒芬太尼与芬太尼麻醉对老年腹腔镜胆囊切除术患者血流动力学及麻醉后苏醒的影响.基层医学论坛,2017,21(32):4468-4469.
[17]刘姗.舒芬太尼应用于腹腔镜手术的麻醉作用探讨.基层医学论坛,2017,21(35):4960-4961.
[18]肖继成.舒芬太尼在腹腔镜手术后静脉镇痛中的应用.中国医刊,2014,49(1):164-165.
[2]张仲金.舒芬太尼复合丙泊酚麻醉在妇科腹腔镜手术中的临床效果观察.中国初级卫生保健,2015,29(2):48-50.
[3]刘娜,邵贵骞,刘艳,等.不同剂量盐酸戊乙奎醚对腹腔镜妇科手术患者呼吸力学的影响.医学研究杂志,2014,43(10):81-85.
[4]彭文平,王巧恒,左明章.复合异丙酚时舒芬太尼抑制双腔支气管导管插管反应的半数有效剂量.中华麻醉学杂志,2015,35(12):1470-1472.
[5]徐嘉莹,桑诺尔,任丽英,等.不同舒芬太尼配置浓度对术后患者静脉自控镇痛效果和不良反应的影响.中国医学科学院学报,2017,39(3):406-410.
[6]史辛波,郑戈,徐佳,等.瑞芬太尼、舒芬太尼全凭静脉麻醉在妇科腹腔镜手术中的应用.局解手术学杂志,2015(1):52-55.
[7]朱云峰,彭丽,幸吉娟,等.三种剂量舒芬太尼用于患儿腹腔镜手术的麻醉效果.临床麻醉学杂志,2012,28(9):878-881.
[8]孟元光.腹腔镜在妇科领域的应用.腹腔镜外科杂志,2012,17(5):395-397.
[9]何亮亮,李炜,陈明慧,等.不同靶控浓度舒芬太尼在全麻诱导气管插管中对血流动力学的影响.临床麻醉学杂志,2008,24(1):29-31.
[10]黎海平,石少梅,李宇,等.不同剂量舒芬太尼应用于妇科腹腔镜手术麻醉中的临床效果.蛇志,2017,29(1):14-16.
[11]黎海平,石少梅,李宇,等.舒芬太尼在妇科腹腔镜手术麻醉中的应用进展.医学综述,2017,23(7):1388-1392.
[12]宋斌,蒋晧宇,闫鑫,等.靶控输注舒芬太尼或瑞芬太尼用于妇科腹腔镜手术麻醉的临床研究.新疆医科大学学报,2017,40(6):751-754.
[13]樊素雄,李春涛.妇科腹腔镜手术老年患者应用舒芬太尼复合异丙酚麻醉的应用疗效.临床医药文献电子杂志,2016,3(14):2850-2851.
[14]陈玉,张文强,邱小凤.宫腔镜手术中应用舒芬太尼与瑞芬太尼复合丙泊酚麻醉的效果对比.中外医疗,2016,35(20):121-123.
[15]杨立军,哈春芳.不同麻醉药在妇科腹腔镜手术中镇痛效果的临床观察.宁夏医学杂志,2017,39(9):830-832.
[16]曹玲.舒芬太尼与芬太尼麻醉对老年腹腔镜胆囊切除术患者血流动力学及麻醉后苏醒的影响.基层医学论坛,2017,21(32):4468-4469.
[17]刘姗.舒芬太尼应用于腹腔镜手术的麻醉作用探讨.基层医学论坛,2017,21(35):4960-4961.
[18]肖继成.舒芬太尼在腹腔镜手术后静脉镇痛中的应用.中国医刊,2014,49(1):164-165.