摘要
目的探讨丙帕他莫与舒芬太尼在功能性鼻内镜手术术后静脉自控镇痛效果的比较。方法选择全麻择期下行功能性鼻内窥镜手术的患者60例,年龄30~65岁,ASA分级Ⅱ~Ⅲ级,随机分为两组,每组30例,两组术毕均即刻连接自控静脉镇痛泵(PCIA)。丙帕他莫组(P组):丙帕他莫2 g+右美托咪定5μg/kg+生理盐水共100 mL。舒芬太尼组(S组):舒芬太尼2μg/kg+右美托咪定5μg/kg+生理盐水共100 mL,术毕静脉注射负荷量2 mL,背景剂量2 mL/h持续输注,自控给药单次追加剂量0.5 mL/h,PCIA锁定时间为15 min,患者持续使用镇痛泵24 h。观察并记录两组患者术后T1(3 h)、T2(6 h)、T3(12 h)、T4(24 h)的VAS评分、Ramsay评分、BCS布氏舒适度评级;记录两组患者术后初次下床活动时间;两组患者术后PCIA的按压次数;术后不良反应(如恶心、呕吐、嗜睡、呼吸抑制等)的发生率;两组患者关于术后镇痛效果的总体满意度。结果术后T1、T2、T3、T4时间点的VAS疼痛评分两组差异无统计学意义(P>0.05),Ramsay镇静评分S组明显高于P组,差异有统计学意义(P<0.05),BCS布氏舒适度模拟评级S组高于P组,差异有统计学意义(P<0.05);术后不良反应(恶心、呕吐、嗜睡、呼吸抑制等)发生率P组明显低于S组,差异有统计学意义(P<0.05);术后PCIA的按压次数P组高于S组,差异有统计学意义(P<0.05);患者对术后镇痛效果的总体满意度P组明显高于S组,差异有统计学意义(P<0.05)。结论丙帕他莫联合右美托咪定应用于功能性鼻内镜手术术后静脉自控镇痛的效果确切,不良反应少,具有可行性。
Objective To compare the efficacies of propatamol and sufentanil in intravenous controlled analgesia after functional endoscopic nasal surgery.Methods Sixty patients with nasal endoscopic surgery under general anesthesia,aged 30-65 years old,ASAⅡ-Ⅲ,were randomly divided into two groups(n=30);and both group immediately received self-control vein analgesia pump.Propatamol group(Group P),received propatamol 2 g+dexmedetomidine 5μg/kg+0.9%normal saline 100 mL;while sufentanil group(Group S)received sufentanil 2μg/kg+dexmedetomidine 5μg/kg+0.9%normal saline 100 mL.The postoperative VAS scores at T1(3 h),T2(6 h),T3(12 h)and T4(24 h),Ramsay score and BCS Brinell comfort rating were observed and recorded.The time of leaving the bed for the first time after surgery was recorded.The number of PCIA press after operation,the incidence of postoperative nausea,vomiting,drowsiness,respiratory depression and other adverse reactions were recorded.Overall satisfaction with postoperative analgesia was also recorded.Results There was no significant difference in postoperative VAS pain scores at T1,T2,T3 or T4 between the two groups(P>0.05).Ramsay sedation score in Group S was significantly higher than that in Group P,so was and BCS Brinell comfort simulated rating(P<0.05).The incidence of postoperative adverse reactions such as nausea,vomiting,drowsiness and respiratory depression in Group P was significantly lower than that in Group S(P<0.05).Postoperative PCIA pressure times in Group P was significantly higher than that in Group S(P<0.05).The overall satisfaction of patients with postoperative analgesia in Group P was significantly higher than that in Group S(P<0.05).Conclusion Propatamol combined with dexmedetomidine in the control of intravenous analgesia after functional endoscopic nasal surgery has a definite effect and less adverse reactions.
作者
揣敬轩
吴巧玲
王昊
CHUAI Jing-xuan;WU Qiao-ling;WANG Hao(Department of Anesthesiology,the First Affiliated Hospital of Jinzhou Medical University,Jinzhou 121001,Liaoning,China)
出处
《广东医学》
CAS
2022年第1期80-84,共5页
Guangdong Medical Journal
基金
辽宁省科学技术计划项目(20180550806)。
关键词
鼻内窥镜手术
丙帕他莫
舒芬太尼
自控静脉镇痛泵
nasal endoscopic surgery
propacetamol
sulfentany
auto-controlled intravenous analgesia pump
