丙帕他莫超前镇痛配合舒芬太尼术后静脉镇痛对乳腺癌术后疼痛的影响

目的：探讨丙帕他莫超前镇痛配合舒芬太尼术后静脉镇痛对乳腺癌术后疼痛的影响。方法采用随机综合平衡序贯法将该院于2013年1月至2015年11月收治的69例拟行外科手术的乳腺癌患者分为观察组（34例）和对照组（35例）。对照组给予单纯舒芬太尼术后静脉镇痛，观察组给予丙帕他莫超前镇痛＋舒芬太尼术后静脉镇痛。对比两组术后1h、4h、8h、12h和24 h疼痛程度和认知功能，并观察不良反应。结果术后1 h两组VAS和MMES评分差异均无统计学意义（P＞0．05），术后4 h、8 h、12 h和24 h观察组VAS和MMES评分均较对照组显著降低（P＜0．05），且术后4 h、8 h和12 h均较术后1 h显著升高（P＜0．05），术后24 h均较术后1 h显著降低（P＜0．05），术后24h均较术后4 h、8 h和12 h显著降低（P＜0．05）；观察组镇痛泵按压次数明显少于对照组，差异有统计学意义（ P＜0．05）；观察组总不良反应发生率为5．88％，较对照组的25．71％显著降低（ P＜0．05）。结论采用丙帕他莫超前镇痛配合舒芬太尼术后静脉镇痛可以显著减轻乳腺癌患者术后疼痛程度，还可改善认知功能，且不良反应少，安全可靠，成效显著。

Effects of propacetamol preemptive analgesia combined with sufentanil for postoperative intravenous analgesia on postoperative pain in patients with breast cancer

Objective To explore the effects of propacetamol preemptive analgesia combined with sufentanil for postoperative in‐travenous analgesia on postoperative pain in patients with breast cancer .Methods 69 cases of patients with breast cancer who nee‐ded surgery operation in our hospital from January 2013 to November 2015 were devided into observation group(34 cases) and con‐trol group(35 cases) by the stochastic comprehensive equilibrium sequential method .The control group were given single sufentanil for postoperative intravenous analgesia ,and the observation group were given propacetamol preemptive analgesia combined with sufentanil for postoperative intravenous analgesia .The degrees of pain and cognitive function of patients in the two groups at 1h , 4h ,8h ,12h and 24h postoperation were compared ,and the adverse reactions were observed .Results There were no significant differences between the two groups in VAS and MMES scores at 1h postoperation(P>0 .05) ,of which the observation group were significantly lower than those in the control group at 4h ,8h ,12h and 24h postoperation(P<0 .05) ,and the VAS and MMES scores in the two groups at 4h ,8h ,12h postoperation were significantly higher than those at 1h postoperation ,which at 24h postoperation were significantly lower than those at 1h postoperation ,and those at 24h postoperation were significantly lower than those at 4h , 8h ,12h postoperation(P<0 .05) .The times of pressing analgesia pump in the observation group were significantly less than those in the control group ,and the differences were statistically significant (P<0 .05) .The incidence of total adverse reactions in the ob‐servation group was 5 .88% ,significantly lower than that of 25 .71% in the control group (P<0 .05) .Conclusion The application of propacetamol preemptive analgesia combined with sufentanil for postoperative intravenous analgesia can significantly reduce the degree of postoperative pain in patients with breast cancer ,and also can improve cognitive function ,with less adverse reactions ,safe and reliable ,w hich has remarkable results .