中国临床实用医学
中國臨床實用醫學
중국림상실용의학
CHINA CLINICAL PRACTICAL MEDICINE
2010年
9期
65-67
,共3页
周少朋%候冰宗%欧珊珊%范东毅%肖笑雨
週少朋%候冰宗%歐珊珊%範東毅%肖笑雨
주소붕%후빙종%구산산%범동의%초소우
帕瑞昔布钠%瑞芬太尼%痛觉过敏
帕瑞昔佈鈉%瑞芬太尼%痛覺過敏
파서석포납%서분태니%통각과민
Parecoxib%Remifentanil%Hyperalgesia
目的 探讨帕瑞昔布钠对瑞芬太尼麻醉后痛敏反应的抑制作用,为临床合理应用瑞芬太尼提供理论指导.方法 选择ASA Ⅰ～Ⅱ级腹腔镜手术患者60例,随机分为对照组(A组)和帕瑞昔布钠组(B组)两组,每组30例.均采用静吸复合麻醉,两组诱导方法相同,以0.2～0.4μg/(kg·min)瑞芬太尼和1.5%～3%七氟烷维持麻醉.B组在缝皮前静脉给予帕瑞昔布钠40 mg,记录两组术前(T0)、术毕(T1)、苏醒(T2)、拔管即刻(T3)、拔管后10 min(T4)及拔管后30 min(T5)血压(MAP)、心率(HR)、血氧饱和度(SpO2)以及术后苏醒时间、拔管时间、Ramsay评分、口述疼痛评分(VRS)和不良反应.结果 A组患者T2、T3、T4及T5时点的MAP、HR均高于T0(P＜0.05),且高于B组(P＜0.05).B组患者苏醒时Ramsay评分和VRS评分均明显优于A组(P＜0.05).两组患者术后均无明显的呼吸抑制和恶心呕吐的发生,但B组患者术后躁动率明显低于A组(P＜0.05).结论 帕瑞昔布钠对瑞芬太尼麻醉后的痛觉过敏有明显的抑制作用,且不增加不良反应.
目的 探討帕瑞昔佈鈉對瑞芬太尼痳醉後痛敏反應的抑製作用,為臨床閤理應用瑞芬太尼提供理論指導.方法 選擇ASA Ⅰ～Ⅱ級腹腔鏡手術患者60例,隨機分為對照組(A組)和帕瑞昔佈鈉組(B組)兩組,每組30例.均採用靜吸複閤痳醉,兩組誘導方法相同,以0.2～0.4μg/(kg·min)瑞芬太尼和1.5%～3%七氟烷維持痳醉.B組在縫皮前靜脈給予帕瑞昔佈鈉40 mg,記錄兩組術前(T0)、術畢(T1)、囌醒(T2)、拔管即刻(T3)、拔管後10 min(T4)及拔管後30 min(T5)血壓(MAP)、心率(HR)、血氧飽和度(SpO2)以及術後囌醒時間、拔管時間、Ramsay評分、口述疼痛評分(VRS)和不良反應.結果 A組患者T2、T3、T4及T5時點的MAP、HR均高于T0(P＜0.05),且高于B組(P＜0.05).B組患者囌醒時Ramsay評分和VRS評分均明顯優于A組(P＜0.05).兩組患者術後均無明顯的呼吸抑製和噁心嘔吐的髮生,但B組患者術後躁動率明顯低于A組(P＜0.05).結論 帕瑞昔佈鈉對瑞芬太尼痳醉後的痛覺過敏有明顯的抑製作用,且不增加不良反應.
목적 탐토파서석포납대서분태니마취후통민반응적억제작용,위림상합리응용서분태니제공이론지도.방법 선택ASA Ⅰ～Ⅱ급복강경수술환자60례,수궤분위대조조(A조)화파서석포납조(B조)량조,매조30례.균채용정흡복합마취,량조유도방법상동,이0.2～0.4μg/(kg·min)서분태니화1.5%～3%칠불완유지마취.B조재봉피전정맥급여파서석포납40 mg,기록량조술전(T0)、술필(T1)、소성(T2)、발관즉각(T3)、발관후10 min(T4)급발관후30 min(T5)혈압(MAP)、심솔(HR)、혈양포화도(SpO2)이급술후소성시간、발관시간、Ramsay평분、구술동통평분(VRS)화불량반응.결과 A조환자T2、T3、T4급T5시점적MAP、HR균고우T0(P＜0.05),차고우B조(P＜0.05).B조환자소성시Ramsay평분화VRS평분균명현우우A조(P＜0.05).량조환자술후균무명현적호흡억제화악심구토적발생,단B조환자술후조동솔명현저우A조(P＜0.05).결론 파서석포납대서분태니마취후적통각과민유명현적억제작용,차불증가불량반응.
Objective To study the suppressive effects of parecoxib on postoperative hyperalgesia after remifentanil-based anesthesia. Methods 60 ASA grade Ⅰ - Ⅱ patients undergoing selective laparoscopic operations were randomly divided into two groups (n = 30) :controlled group (group A) and parecoxib group B (group B). Midazolam(0.05 mg/kg) ,remifentanil (1μg/kg) ,propofol (2 mg/kg) and atracrium (0. 6 mg/kg) were administered for anesthesia induction, and 0. 2 ～ 0. 4 μg/( kg · min ) remifentanil and 1.5 % ～ 3% sevoflurane were given for anesthesia maintenance in the two groups. At skin closure parecoxib 40 mg was intravenous injected in group B ,and group A received no drug infusion. MAP, HR and SpO2 was recorded at the time points of entering the operation room ( T0 ), completion of the operation ( T1 ), wake up ( T2 ) , extubation ( T3 ), 10 minutes after extubation ( T4 ) and 30 minutes after extubation ( T5 ). The time of awake, the time of extubation and the adverse effects were recorded. The Ramsay sedation score and VRS score were evaluated. Results In group A,MAP and HR of T2, T3 T4 and T5 were remarkable higher than T0 ( P ＜ 0. 05 ) , and also higher than those of group B ( P ＜ 0. 05 ). The Ramsay sedation score and VRS score in group B were much better than those in group A ( P ＜ 0. 05 ). Compared with group A, the rate of restlessness of group B was obviously lower( P ＜ 0. 05 ). Con-clusion Parecoxib has significant suppressive effect on patients with postoperative hyperalgesia after remifentanil-based anesthesia.
