舒芬太尼联合格拉司琼在腹腔镜全子宫切除术后静脉自控镇痛中的应用

目的探讨舒芬太尼联合格拉司琼在腹腔镜全子宫切除术后静脉自控镇痛(PCIA)中的可行性。方法90例择期腹腔镜全子宫切除术患者,术后采用静脉自控镇痛,随机分3组各30例,A组:芬太尼20μg/kg;B组:舒芬太尼2μg/kg;C组:舒芬太尼2μg/kg+格拉司琼60μg/kg,所用药物用生理盐水稀释至100ml。观察患者术后4、8、12、24和48h的VAS评分、恶心呕吐发生率等不良反应。结果 3组患者均有良好的镇痛效果,但A组PCA次数多于B、C组(P<0.05);C组恶心呕吐发生率低于A、B组(P<0.05)。结论芬太尼、舒芬太尼均能减轻腹腔镜全子宫切除术后疼痛,但舒芬太尼镇痛效果更佳;联合格拉司琼能有效减少腹腔镜全子宫切除术后恶心呕吐的发生率。

Clinical Application of Sufentanil in combination with granisetron after total laparoscopic hysterectomy

Objective To study the clicnical application of sufentanil combined with granisetron after laparoseopic hysterectomy patient-controlled intravenous analgesia （PCIA） feasibility. Methods Ninety patients undergoing laparoscopic hysterectomy patients, using postoperative patient-controlled intravenous analgesia, were randomly divided into three groups of thirty patients each, group A： group B.. sufentanil fentanyl 20ug/kg, 2ug/kg; group C： with 2ug/kg＋ granisetron 60ug/kg, the drug was diluted with saline to 100 mL. Observation of postoperative patients with 4h, 8h, 12h, 24h, 48h, VAS score, the incidence of nausea and vomiting and other adverse reactions. Results Three patients had a good analgesic effect, but group A PCA more than B, C group （P〈0.05） ; the incidence of nausea and vomiting in group C than group B （A, P〈0.05）. Conclusion Fentanyl, sufentanil can relieve pain after laparoscopie total hysterectomy, but sufentanil analgesia effect, granisetron combined with laparoscopic hysterectomy can effectively reduce the occurrence of postoperative nausea and vomiting.