安徽医药
安徽醫藥
안휘의약
ANHUI MEDICAL AND PHARMACEUTICAL JOURNAL
2015年
1期
87-90
,共4页
地佐辛%帕瑞昔布钠%地塞米松%多模式超前镇痛%妇科腹腔镜手术
地佐辛%帕瑞昔佈鈉%地塞米鬆%多模式超前鎮痛%婦科腹腔鏡手術
지좌신%파서석포납%지새미송%다모식초전진통%부과복강경수술
dezocine%parecoxib%dexamethasone%preemptive multimodal analgesia (PMMA)%gynaecological laparoscopic surgery
目的:探讨多模式超前镇痛在妇科腹腔镜手术的术后镇痛作用。方法80例择期行妇科腹腔镜手术患者,ASAⅠ~Ⅱ级,年龄25~64岁,随机双盲分为对照组(C 组)、地佐辛组(D 组)、帕瑞昔布钠组(P 组)、多模式镇痛组(PM组),每组20例,分别于麻醉诱导前5 min 给予生理盐水、地佐辛10 mg、帕瑞昔布钠40 mg 及地塞米松10 mg、地佐辛10 mg,复合帕瑞昔布钠40 mg 静脉注射。各组麻醉维持采用异丙酚和瑞芬太尼静脉麻醉,统计各组术中瑞芬太尼用量(RFC),记录术后患者拔除喉罩后0、1、2、4、8、12、24 h(T 1-7)的疼痛视觉模拟评分(VAS 评分),记录术后各组补救镇痛的时间和剂量,观察术后不良反应。结果C 组术中瑞芬太尼用量多于其他各组。拔除喉罩后0、1、2、4、8、12 h 的 VAS 评分,D 组、P 组均低于 C 组(P <0.05),PM组低于 D 组、P 组、C 组(P <0.05)。各组中患者于拔出喉罩后1、2、4 h 需要补救镇痛的例数,C 组多于 D 组、P 组(P <0.05),而 PM组不需要补救镇痛(P <0.05)。其他不良反应无明显差异。结论多模式超前镇痛在妇科腹腔镜手术有更好的镇痛效果,明显优于单一用药。
目的:探討多模式超前鎮痛在婦科腹腔鏡手術的術後鎮痛作用。方法80例擇期行婦科腹腔鏡手術患者,ASAⅠ~Ⅱ級,年齡25~64歲,隨機雙盲分為對照組(C 組)、地佐辛組(D 組)、帕瑞昔佈鈉組(P 組)、多模式鎮痛組(PM組),每組20例,分彆于痳醉誘導前5 min 給予生理鹽水、地佐辛10 mg、帕瑞昔佈鈉40 mg 及地塞米鬆10 mg、地佐辛10 mg,複閤帕瑞昔佈鈉40 mg 靜脈註射。各組痳醉維持採用異丙酚和瑞芬太尼靜脈痳醉,統計各組術中瑞芬太尼用量(RFC),記錄術後患者拔除喉罩後0、1、2、4、8、12、24 h(T 1-7)的疼痛視覺模擬評分(VAS 評分),記錄術後各組補救鎮痛的時間和劑量,觀察術後不良反應。結果C 組術中瑞芬太尼用量多于其他各組。拔除喉罩後0、1、2、4、8、12 h 的 VAS 評分,D 組、P 組均低于 C 組(P <0.05),PM組低于 D 組、P 組、C 組(P <0.05)。各組中患者于拔齣喉罩後1、2、4 h 需要補救鎮痛的例數,C 組多于 D 組、P 組(P <0.05),而 PM組不需要補救鎮痛(P <0.05)。其他不良反應無明顯差異。結論多模式超前鎮痛在婦科腹腔鏡手術有更好的鎮痛效果,明顯優于單一用藥。
목적:탐토다모식초전진통재부과복강경수술적술후진통작용。방법80례택기행부과복강경수술환자,ASAⅠ~Ⅱ급,년령25~64세,수궤쌍맹분위대조조(C 조)、지좌신조(D 조)、파서석포납조(P 조)、다모식진통조(PM조),매조20례,분별우마취유도전5 min 급여생리염수、지좌신10 mg、파서석포납40 mg 급지새미송10 mg、지좌신10 mg,복합파서석포납40 mg 정맥주사。각조마취유지채용이병분화서분태니정맥마취,통계각조술중서분태니용량(RFC),기록술후환자발제후조후0、1、2、4、8、12、24 h(T 1-7)적동통시각모의평분(VAS 평분),기록술후각조보구진통적시간화제량,관찰술후불량반응。결과C 조술중서분태니용량다우기타각조。발제후조후0、1、2、4、8、12 h 적 VAS 평분,D 조、P 조균저우 C 조(P <0.05),PM조저우 D 조、P 조、C 조(P <0.05)。각조중환자우발출후조후1、2、4 h 수요보구진통적례수,C 조다우 D 조、P 조(P <0.05),이 PM조불수요보구진통(P <0.05)。기타불량반응무명현차이。결론다모식초전진통재부과복강경수술유경호적진통효과,명현우우단일용약。
Objective To determine the effect of preemptive multimodal analgesia in the patients undergoing gynaecological laparoscop-ic surgery.Methods Eighty patients aged 25 to 64 years old,ASAⅠ ~Ⅱ,undergoing selective gynaecological laparoscopic surgery were prospectively,randomly and double-blinded assigned into four groups (n =20),control group (C group),dezocine group (D group),parecoxib group (P group)and preemptive multimodal analgesia group (PMgroup).C group was given normal saline intrave-nously,D group dezocine 10mg,P group parecoxib 40 mg and PMgroup ezocine 10 mg plus parecoxib 40 mg plus dexamethasone10 mg 5 minutes before induction.The anesthesia was maintained with intravenous propofol and emifentanil.The average of remifentanil con-sumption was counted.The VAS scales were recorded 0,1,2,4,8,12,24 h(T 1 -7)after extubation.The induction and postoperative complications were recorded.Results The average remifentanil consumption(RFC)of C group was higher than the other three groups. VAS scales of D group and P group were lower than C group’s(P <0.05)and the VAS scales of PMgroup were lower than D group’ s,P group’s and C group’s at the time of 0、1、2、4、8、12 h after extubation(P <0.05).More patients in C group needed rescue anes-thetics 1,2 or 4 h after extubation than D,T group’s,and patients in PMgroup didn’t need any rescue anesthetics (P <0.05).There was no difference in other complications between the four groups.Conclusions The preemptive multimodal analgesia was more effec-tive than preemptive analgesia with single analgesic in laparoscopic cholecystectomy.