国际麻醉学与复苏杂志
國際痳醉學與複囌雜誌
국제마취학여복소잡지
INTERNATIONAL JOURNAL OF ANESTHESIOLOGY AND RESUSCITATION
2013年
12期
1079-1082
,共4页
氟比洛芬酯%曲马多%超前镇痛%苏醒期躁动
氟比洛芬酯%麯馬多%超前鎮痛%囌醒期躁動
불비락분지%곡마다%초전진통%소성기조동
Flurbiprofen axetil%Tramadol%Preemptive analgesia%Postoperative agitation
目的 比较氟比洛芬酯和曲马多在七氟醚全身麻醉术前应用的效果及对其苏醒期躁动的预防作用. 方法 60例择期肝胆手术患者按完全随机分组法分成氟比洛芬酯组、曲马多组和生理盐水组,每组20例.手术开始前10 min,氟比洛芬酯组静脉注射氟比洛芬酯1 mg/kg,曲马多组静脉注射曲马2 mg/kg,生理盐水组静脉注射生理盐水10 ml,分别于T1(麻醉诱导前)、T2[拔除气管导管前(停药10 min)]、T3(拔管时)、T4(拔管后10 min),观察3组平均动脉压(mean artery pressure,MAP)、心率(heartrate,HR)、脉搏血氧饱和度(pulseoxygen saturation,SpO2)、睁眼时间、拔管时间、术后疼痛评分和躁动分级. 结果 氟比洛芬酯、曲马多组在T2、T3、T4 3个时间点的血压、HR明显低于生理盐水组(P＜0.05或P＜0.01),无SpO2低者.氟比洛芬酯组睁眼及拔管时间分别为(11±4) min和(13±3) min,生理盐水组睁眼及拔管时间分别为(11±3) min和(14±3)min,均明显短于曲马多组睁眼[(15±4) min]及拔管时间[(18±5) min](P＜0.05或P＜0.01).躁动发生率氟比洛芬酯组(0)和曲马多组(20％)明显低于生理盐水组(55％)(P＜0.05或P＜0.01).视觉模拟评分(visual analogue scale,VAS)术后0.5、2 h,氟比洛芬酯组[(2.2±0.6)、(2.1±0.8)]和曲马多组[(3.0±1.1)、(2.6±1.0)]明显低于生理盐水组[(4.1±0.7)、(3.9±0.6)](P＜0.05). 结论 氟比洛芬酯和曲马多用于七氟醚全身麻醉可产生良好的超前镇痛作用,并可预防术后躁动的发生,但曲马多对患者的苏醒有延迟作用.
目的 比較氟比洛芬酯和麯馬多在七氟醚全身痳醉術前應用的效果及對其囌醒期躁動的預防作用. 方法 60例擇期肝膽手術患者按完全隨機分組法分成氟比洛芬酯組、麯馬多組和生理鹽水組,每組20例.手術開始前10 min,氟比洛芬酯組靜脈註射氟比洛芬酯1 mg/kg,麯馬多組靜脈註射麯馬2 mg/kg,生理鹽水組靜脈註射生理鹽水10 ml,分彆于T1(痳醉誘導前)、T2[拔除氣管導管前(停藥10 min)]、T3(拔管時)、T4(拔管後10 min),觀察3組平均動脈壓(mean artery pressure,MAP)、心率(heartrate,HR)、脈搏血氧飽和度(pulseoxygen saturation,SpO2)、睜眼時間、拔管時間、術後疼痛評分和躁動分級. 結果 氟比洛芬酯、麯馬多組在T2、T3、T4 3箇時間點的血壓、HR明顯低于生理鹽水組(P＜0.05或P＜0.01),無SpO2低者.氟比洛芬酯組睜眼及拔管時間分彆為(11±4) min和(13±3) min,生理鹽水組睜眼及拔管時間分彆為(11±3) min和(14±3)min,均明顯短于麯馬多組睜眼[(15±4) min]及拔管時間[(18±5) min](P＜0.05或P＜0.01).躁動髮生率氟比洛芬酯組(0)和麯馬多組(20％)明顯低于生理鹽水組(55％)(P＜0.05或P＜0.01).視覺模擬評分(visual analogue scale,VAS)術後0.5、2 h,氟比洛芬酯組[(2.2±0.6)、(2.1±0.8)]和麯馬多組[(3.0±1.1)、(2.6±1.0)]明顯低于生理鹽水組[(4.1±0.7)、(3.9±0.6)](P＜0.05). 結論 氟比洛芬酯和麯馬多用于七氟醚全身痳醉可產生良好的超前鎮痛作用,併可預防術後躁動的髮生,但麯馬多對患者的囌醒有延遲作用.
목적 비교불비락분지화곡마다재칠불미전신마취술전응용적효과급대기소성기조동적예방작용. 방법 60례택기간담수술환자안완전수궤분조법분성불비락분지조、곡마다조화생리염수조,매조20례.수술개시전10 min,불비락분지조정맥주사불비락분지1 mg/kg,곡마다조정맥주사곡마2 mg/kg,생리염수조정맥주사생리염수10 ml,분별우T1(마취유도전)、T2[발제기관도관전(정약10 min)]、T3(발관시)、T4(발관후10 min),관찰3조평균동맥압(mean artery pressure,MAP)、심솔(heartrate,HR)、맥박혈양포화도(pulseoxygen saturation,SpO2)、정안시간、발관시간、술후동통평분화조동분급. 결과 불비락분지、곡마다조재T2、T3、T4 3개시간점적혈압、HR명현저우생리염수조(P＜0.05혹P＜0.01),무SpO2저자.불비락분지조정안급발관시간분별위(11±4) min화(13±3) min,생리염수조정안급발관시간분별위(11±3) min화(14±3)min,균명현단우곡마다조정안[(15±4) min]급발관시간[(18±5) min](P＜0.05혹P＜0.01).조동발생솔불비락분지조(0)화곡마다조(20％)명현저우생리염수조(55％)(P＜0.05혹P＜0.01).시각모의평분(visual analogue scale,VAS)술후0.5、2 h,불비락분지조[(2.2±0.6)、(2.1±0.8)]화곡마다조[(3.0±1.1)、(2.6±1.0)]명현저우생리염수조[(4.1±0.7)、(3.9±0.6)](P＜0.05). 결론 불비락분지화곡마다용우칠불미전신마취가산생량호적초전진통작용,병가예방술후조동적발생,단곡마다대환자적소성유연지작용.
Objective To compare the preemptive analgesia effect of flurbiprofen axetil and tramadol in sevoflurane general anasthesia and evaluate the preventive effect of flurbiprofen axetil and tramadol on postoperative agitation.Methods Sixty ASA Ⅰ-Ⅱ patients undergoing choledochotomy were randomly assigned into three groups,which received either a bolus of 1 mg/kg flurbiprofen axetil(the flurbiprofen axetil group,20 cases) or 2 mg/kg tramadol(the tramadol group,20 cases) or 10 ml normal saline (the normal saline group,20 cases),10 min before the surgery.The heart rate (HR),mean arterial blood pressure (MAP) and pulse oxygen saturation (SpO2) before induction of anesthesia and peri-extubation,the moment of eyes opening and extubation,and the degree of postoperative agitation were recorded.Results The MAP、HR in the flurbiprofen axetil group and the tramadol group were significantly lower than that of the normal saline group peri-extubation(P＜0.05 or P＜0.01),SpO2 was not significantly different in all groups.The time of eye opening and extubation in the flurbiprofen axetil group [(11 ±4),(13±3) min] were significantly shorter than that of the tramadol group [(15±4),(18±5) min] (P＜0.05).The emergence of postoperative agitation in the flurbiprofen axetil group(0) and the tramadol group(20％) were significantly better than that of the normal saline group(55％)(P＜0.05 or P＜0.01),and the visual analogue score in the flurbiprofen axetil group[(2.2±0.6),(2.1±0.8)] and the tramadol group[(3.0±1.1),(2.6±1.0)] after the operation finished 0.5 h and 2 h were significantly better than that of the normal saline group [(4.1 ±0.7),(3.9±0.6)] (P＜0.05).Conclusions Applying of flurbiprofen axetil and tramadol in sevoflurane general anasthesia can provide a good effect of preemptive analgesia and prevent postoperative agitation.But tramadol would prolong the waking time of patients.
