中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2011年
22期
9-10
,共2页
芬太尼%曲马多%瑞芬太尼%全麻%苏醒期
芬太尼%麯馬多%瑞芬太尼%全痳%囌醒期
분태니%곡마다%서분태니%전마%소성기
Fentanyl%Tramadol%Remifentanil%General anesthesia%Recovering period
目的 观察芬太尼复合曲马多减轻瑞芬太尼全麻苏醒期疼痛的效果.方法 选择妇科宫外孕和卵巢囊肿患者共90例,ASA分级Ⅰ～Ⅱ级,手术时间1.5h以内,随机分为T组、F组和T+F组,术中以持续靶控输注丙泊酚和瑞芬太尼,间断给予维库溴铵维持麻醉.T组患者手术结束前30 min给予曲马多2 mg/kg,F组患者手术结束前10 min给予芬太尼2μg/kg.T+F组手术结束前30 min给予曲马多1.5 mg/kg,手术结束前10 min再给予芬太尼1 μg/kg,记录呼吸恢复时间、苏醒时间,警觉/镇静评分(OAA/S)、拔管后VAS评分和不良反应.结果三组患者手术结束后呼吸恢复时间、苏醒时间、OAA/S评分和瘙瘁、躁动比较差异均无统计学意义(P＞0.05),麻醉拔管后均无呼吸抑制、恶心、呕吐发生.拔管后T组、F组VAS评分比较差异无统计学意义(P＞0.05),T+F组VAS评分和T、F组比较差异有统计学意义(P＜0.05).结论 预防瑞芬太尼全麻术后苏醒期疼痛,芬太尼复合曲马多较单一使用芬太尼或曲马多更有优势.
目的 觀察芬太尼複閤麯馬多減輕瑞芬太尼全痳囌醒期疼痛的效果.方法 選擇婦科宮外孕和卵巢囊腫患者共90例,ASA分級Ⅰ～Ⅱ級,手術時間1.5h以內,隨機分為T組、F組和T+F組,術中以持續靶控輸註丙泊酚和瑞芬太尼,間斷給予維庫溴銨維持痳醉.T組患者手術結束前30 min給予麯馬多2 mg/kg,F組患者手術結束前10 min給予芬太尼2μg/kg.T+F組手術結束前30 min給予麯馬多1.5 mg/kg,手術結束前10 min再給予芬太尼1 μg/kg,記錄呼吸恢複時間、囌醒時間,警覺/鎮靜評分(OAA/S)、拔管後VAS評分和不良反應.結果三組患者手術結束後呼吸恢複時間、囌醒時間、OAA/S評分和瘙瘁、躁動比較差異均無統計學意義(P＞0.05),痳醉拔管後均無呼吸抑製、噁心、嘔吐髮生.拔管後T組、F組VAS評分比較差異無統計學意義(P＞0.05),T+F組VAS評分和T、F組比較差異有統計學意義(P＜0.05).結論 預防瑞芬太尼全痳術後囌醒期疼痛,芬太尼複閤麯馬多較單一使用芬太尼或麯馬多更有優勢.
목적 관찰분태니복합곡마다감경서분태니전마소성기동통적효과.방법 선택부과궁외잉화란소낭종환자공90례,ASA분급Ⅰ～Ⅱ급,수술시간1.5h이내,수궤분위T조、F조화T+F조,술중이지속파공수주병박분화서분태니,간단급여유고추안유지마취.T조환자수술결속전30 min급여곡마다2 mg/kg,F조환자수술결속전10 min급여분태니2μg/kg.T+F조수술결속전30 min급여곡마다1.5 mg/kg,수술결속전10 min재급여분태니1 μg/kg,기록호흡회복시간、소성시간,경각/진정평분(OAA/S)、발관후VAS평분화불량반응.결과삼조환자수술결속후호흡회복시간、소성시간、OAA/S평분화소췌、조동비교차이균무통계학의의(P＞0.05),마취발관후균무호흡억제、악심、구토발생.발관후T조、F조VAS평분비교차이무통계학의의(P＞0.05),T+F조VAS평분화T、F조비교차이유통계학의의(P＜0.05).결론 예방서분태니전마술후소성기동통,분태니복합곡마다교단일사용분태니혹곡마다경유우세.
Objective To observe the effect of fentanyl combined with tramadol on alleviating patients' pain after remifentanil anesthesia during the recovering period.Methods Total 90 patients with ectopic pregnancy and ovarian cyst,ASA Ⅰ - Ⅱ,operating time less than 1.5 hours.They were divided into 3 groups randomly,T Group,F Group,and T + F Group,all patients were continuously given target controlled infusion of propofol and remifentanil,and discontinuously given vecuronium to maintain anesthesia.Each patient in T Group was given 2 mg/kg tramadol 30 minutes before the finish of surgery.Each patient in F Group was given 2 μg/kg fentanyl 10 minutes before the finish of surgery.Each patient in T + F Group was given 1.5 mg/kg tramadol 30 minutes before the finish of surgery and given 1 μg/kg fentanyl 10 minutes before the finish of surgery.Breathing recovery time,waking time,OAA/S,VAS grade after removing tube and side effects were recorded.Results There was no statistical difference in breathing recovery time,waking time,OAA/S,itching,or dysphoria after the finish of surgery among the three groups ( P ＞ O.05),No respiratory depression,nausea,or vomiting occurred after removing anesthesia tube among the three groups.There was no statistical difference on VAS grade between T Group and F Group after removing tube ( P ＞ 0.05 ),and there were marked differences on VAS grade between T + F Group and T Group,and between T + F Group and F Group ( P ＜ 0.05).Conclusions For preventing pain during the recovering period from general anesthesia of remifentanil,fentanyl combined with tramadol has more advantages than using single fentanyl or tramadol.
