不同浓度舒芬太尼用于妇科术后静脉镇痛效果的比较
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摘要
目的:探讨妇科患者应用不同浓度舒芬太尼进行麻醉后镇痛效果。方法:选取2016年3月-2018年3月本院收治的妇科手术患者90例。按照随机数字表法将其分为A、B、C组,各30例,分别给予1.5、2.0、2.5μg/kg舒芬太尼进行镇痛。比较三组麻醉诱导前(T1)、术后30 min(T2)、手术结束前1 min(T3)、导管拔除后5 min(T4)、术后1 h(T5)的心率、平均动脉压,比较三组麻醉恢复情况、疼痛程度评分及不良反应发生情况。结果:三组T4、T5的心率、平均动脉压比较差异均有统计学意义(P<0.05),其中B、C组均优于A组(P<0.05);三组麻醉恢复情况、疼痛程度评分比较,差异均有统计学意义(P<0.05),其中A、B组自主呼吸恢复时间、苏醒时间、拔管时间均短于C组(P<0.05),B、C组疼痛程度评分均低于A组(P<0.05);三组嗜睡、头晕发生率比较差异均有统计学意义(P<0.05)。结论:妇科患者应用不同浓度舒芬太尼进行麻醉后镇痛效果显著,2.0μg/kg的剂量具有一定的优越性,既可改善术后疼痛程度,又可提高麻醉恢复情况,值得临床应用。
Objective:To investigate the effect of different concentrations of Sufentanil for intravenous analgesia after gynecological surgery.Method:A total of 90 patients with gynecological surgery admitted to our hospital from March 2016 to March 2018 were selected.According to the method of random number table,they were divided into A,B and C groups,30 cases in each group,and Sufentanil was given 1.5,2.0 and 2.5 μg/kg respectively for analgesia.The heart rate and mean arterial pressure before induction of anesthesia(T1), 30 minutes after operation(T2),1 minute before end of operation(T3),5 minutes after catheter removal(T4)and 1 hour after operation(T5)were compared in three groups,the recovery of anesthesia,pain score and adverse reactions between three groups were compared.Result:The heart rate and mean arterial pressure of T4 and T5 in three groups were compared,the differences were statistically significant(P<0.05),B and C group were better than those of A group(P<0.05).The recovery of anesthesia and the degree of pain were compared in three groups,the differences were statistically significant(P<0.05),and the recovery time of spontaneous breathing,recovery time and extubation time in A and B group were shorter than those of C group(P<0.05),the pain scores in B and C group were lower than those of A group(P<0.05).The incidence of somnolence and dizziness in three groups were compared,the differences were statistically significant(P<0.05).Conclusion:Different concentrations of Sufentanil in gynecological patients have significant analgesic effect after anesthesia.The dosage of 2.0 μg/kg has certain advantages.It can not only improve the degree of pain after operation,but also improve the recovery of anesthesia.It is worthy of clinical application.
Objective:To investigate the effect of different concentrations of Sufentanil for intravenous analgesia after gynecological surgery.Method:A total of 90 patients with gynecological surgery admitted to our hospital from March 2016 to March 2018 were selected.According to the method of random number table,they were divided into A,B and C groups,30 cases in each group,and Sufentanil was given 1.5,2.0 and 2.5 μg/kg respectively for analgesia.The heart rate and mean arterial pressure before induction of anesthesia(T1), 30 minutes after operation(T2),1 minute before end of operation(T3),5 minutes after catheter removal(T4)and 1 hour after operation(T5)were compared in three groups,the recovery of anesthesia,pain score and adverse reactions between three groups were compared.Result:The heart rate and mean arterial pressure of T4 and T5 in three groups were compared,the differences were statistically significant(P<0.05),B and C group were better than those of A group(P<0.05).The recovery of anesthesia and the degree of pain were compared in three groups,the differences were statistically significant(P<0.05),and the recovery time of spontaneous breathing,recovery time and extubation time in A and B group were shorter than those of C group(P<0.05),the pain scores in B and C group were lower than those of A group(P<0.05).The incidence of somnolence and dizziness in three groups were compared,the differences were statistically significant(P<0.05).Conclusion:Different concentrations of Sufentanil in gynecological patients have significant analgesic effect after anesthesia.The dosage of 2.0 μg/kg has certain advantages.It can not only improve the degree of pain after operation,but also improve the recovery of anesthesia.It is worthy of clinical application.
引文
[1]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[J].中国医学科学院学报,2017,39(3):406-410.
[2]康培培,丛顾俊,赵俊才.不同浓度舒芬太尼用于食管癌根治术后患者皮下自控镇痛效果的观察[J].临床肿瘤学杂志,2017,22(2):167-170.
[3]王杰荣.不同浓度舒芬太尼应用于普通腹部手术的老年病人术后静脉自控镇痛的疗效观察[J].泰山医学院学报,2016,37(5):527-528.
[4]王晓燕,郑海燕.氟比洛芬酯复合舒芬太尼用于剖宫产手术后静脉镇痛对新生儿哺乳安全性研究[J].浙江创伤外科,2016,21(2):392-394.
[5]赵楠,吕国义,韩建阁.不同浓度罗哌卡因复合舒芬太尼用于开胸术后硬膜外镇痛的临床研究[J].继续医学教育,2016,30(3):138-141.
[6]王旭,高玉华,郭斌,等.罗哌卡因复合舒芬太尼或地佐辛连续股神经阻滞在全膝关节置换术后镇痛中的应用[J].临床麻醉学杂志,2016,32(3):258-261.
[7]戴晓凤,李海芳,陆惠元,等.高龄患者下腹部手术硬膜外不同浓度左旋布比卡因结合芬太尼术后镇痛效果评价[J].黔南民族医专学报,2015,28(4):247-250,260.
[8]刘鹏飞,关雷.响应曲面模型分析舒芬太尼与氟比洛芬酯药效学间的相互作用[J].中国实验诊断学,2015,19(11):1833-1836.
[9]饶智军.不同浓度罗哌卡因联合舒芬太尼用于子宫下段剖宫产术后镇痛临床观察[J].深圳中西医结合杂志,2015,25(21):103-104.
[10]张忠勤,黄桂连,容惠琼,等.靶控输注不同浓度舒芬太尼在小儿术后镇痛中的有效性和安全性研究[J].广西医学,2015,37(10):1403-1406.
[11]刘鹏飞,关雷.响应曲面法研究术后静脉镇痛舒芬太尼和曲马多的药效学相互作用[J].中国实验诊断学,2015,19(9):1501-1504.
[12]郑建宇,唐群杰,黄广用.盐酸左布比卡因与不同质量浓度枸橼酸舒芬太尼联合用于剖宫产术后自控硬膜外镇痛的疗效观察[J].中国医院用药评价与分析,2015,15(7):898-901.
[13]徐曈,蔡爱香.不同浓度舒芬太尼配伍罗哌卡因在剖宫产术后镇痛中的效果观察[J].中国当代医药,2014,21(26):121-123.
[14]赵江峰,刘华,于鹏,等.不同浓度罗哌卡因配伍咪达唑仑、舒芬太尼对胸外科老年患者术后硬膜外镇痛效果的临床比较[J].中国生化药物杂志,2014,34(5):98-100.
[15]王勇,徐靖宇,雷明灿,等.不同浓度的舒芬太尼用于卵巢癌切除术后静脉自控镇痛的临床研究[J].中国妇幼保健,2014,29(19):3192-3194.
[16]王两忠,王雄.不同舒芬太尼效应室浓度联合舒芬太尼术后镇痛的效果比较[J].四川医学,2014,35(3):341-344.
[17]李洪银.不同浓度舒芬太尼复合左旋布比卡因、托烷司琼在硬膜外自控镇痛的疗效观察[J].青海医药杂志,2013,43(12):21-22.
[18]邢书生,夏晓峰,刘宏磊.不同浓度舒芬太尼混合罗哌卡因用于开腹手术后病人硬膜外自控镇痛的观察[J].临床军医杂志,2013,41(2):194-195.
[19]赵正兰,方琴,祝燕琴.不同浓度舒芬太尼复合小剂量罗哌卡因腰硬联合麻醉在剖宫产术中的应用[J].中国医药导报,2013,10(5):84-85,105.
[20]瞿煦临,李江,张巍,等.不同浓度舒芬太尼复合罗哌卡因鞘内注射在剖宫产术后镇痛中的应用评价[J].现代生物医学进展,2013,13(2):278-280.
[2]康培培,丛顾俊,赵俊才.不同浓度舒芬太尼用于食管癌根治术后患者皮下自控镇痛效果的观察[J].临床肿瘤学杂志,2017,22(2):167-170.
[3]王杰荣.不同浓度舒芬太尼应用于普通腹部手术的老年病人术后静脉自控镇痛的疗效观察[J].泰山医学院学报,2016,37(5):527-528.
[4]王晓燕,郑海燕.氟比洛芬酯复合舒芬太尼用于剖宫产手术后静脉镇痛对新生儿哺乳安全性研究[J].浙江创伤外科,2016,21(2):392-394.
[5]赵楠,吕国义,韩建阁.不同浓度罗哌卡因复合舒芬太尼用于开胸术后硬膜外镇痛的临床研究[J].继续医学教育,2016,30(3):138-141.
[6]王旭,高玉华,郭斌,等.罗哌卡因复合舒芬太尼或地佐辛连续股神经阻滞在全膝关节置换术后镇痛中的应用[J].临床麻醉学杂志,2016,32(3):258-261.
[7]戴晓凤,李海芳,陆惠元,等.高龄患者下腹部手术硬膜外不同浓度左旋布比卡因结合芬太尼术后镇痛效果评价[J].黔南民族医专学报,2015,28(4):247-250,260.
[8]刘鹏飞,关雷.响应曲面模型分析舒芬太尼与氟比洛芬酯药效学间的相互作用[J].中国实验诊断学,2015,19(11):1833-1836.
[9]饶智军.不同浓度罗哌卡因联合舒芬太尼用于子宫下段剖宫产术后镇痛临床观察[J].深圳中西医结合杂志,2015,25(21):103-104.
[10]张忠勤,黄桂连,容惠琼,等.靶控输注不同浓度舒芬太尼在小儿术后镇痛中的有效性和安全性研究[J].广西医学,2015,37(10):1403-1406.
[11]刘鹏飞,关雷.响应曲面法研究术后静脉镇痛舒芬太尼和曲马多的药效学相互作用[J].中国实验诊断学,2015,19(9):1501-1504.
[12]郑建宇,唐群杰,黄广用.盐酸左布比卡因与不同质量浓度枸橼酸舒芬太尼联合用于剖宫产术后自控硬膜外镇痛的疗效观察[J].中国医院用药评价与分析,2015,15(7):898-901.
[13]徐曈,蔡爱香.不同浓度舒芬太尼配伍罗哌卡因在剖宫产术后镇痛中的效果观察[J].中国当代医药,2014,21(26):121-123.
[14]赵江峰,刘华,于鹏,等.不同浓度罗哌卡因配伍咪达唑仑、舒芬太尼对胸外科老年患者术后硬膜外镇痛效果的临床比较[J].中国生化药物杂志,2014,34(5):98-100.
[15]王勇,徐靖宇,雷明灿,等.不同浓度的舒芬太尼用于卵巢癌切除术后静脉自控镇痛的临床研究[J].中国妇幼保健,2014,29(19):3192-3194.
[16]王两忠,王雄.不同舒芬太尼效应室浓度联合舒芬太尼术后镇痛的效果比较[J].四川医学,2014,35(3):341-344.
[17]李洪银.不同浓度舒芬太尼复合左旋布比卡因、托烷司琼在硬膜外自控镇痛的疗效观察[J].青海医药杂志,2013,43(12):21-22.
[18]邢书生,夏晓峰,刘宏磊.不同浓度舒芬太尼混合罗哌卡因用于开腹手术后病人硬膜外自控镇痛的观察[J].临床军医杂志,2013,41(2):194-195.
[19]赵正兰,方琴,祝燕琴.不同浓度舒芬太尼复合小剂量罗哌卡因腰硬联合麻醉在剖宫产术中的应用[J].中国医药导报,2013,10(5):84-85,105.
[20]瞿煦临,李江,张巍,等.不同浓度舒芬太尼复合罗哌卡因鞘内注射在剖宫产术后镇痛中的应用评价[J].现代生物医学进展,2013,13(2):278-280.