舒芬太尼和地佐辛预防瑞芬太尼麻醉后疼痛过敏的效果比较

目的 比较舒芬太尼和地佐辛预防瑞芬太尼麻醉后疼痛过敏效果及不良反应发生情况。方法 选择2017年6月~2019年6月在我院行腹腔镜下子宫次全切术和子宫全切术患者40例，采用随机数字表法分为对照组和观察组，各20例。对照组术毕给予地佐辛预防瑞芬太尼麻醉后疼痛过敏治疗，观察组术毕给予舒芬太尼预防治疗，比较两组呼吸恢复时间、苏醒时间、拔管时心率（HR）和平均动脉压（MAP）、不同时间段[拔管即刻（T1）、拔管后10 min（T2）、拔管后1 h（T3）]疼痛（VAS）评分以及临床不良反应（恶心、呕吐、躁动、呛咳）发生情况。结果 观察组呼吸恢复时间、苏醒时间、拔管时HR和MAP与对照组比较，差异无统计学意义（P＞0.05）；观察组T1、T2时间段VAS评分与对照组比较，差异无统计学意义（P＞0.05）；T3时间段VAS评分低于对照组，差异有统计学意义（P＜0.05）；观察组不良反应总发生率（20.00%）低于对照组（40.00%），差异有统计学意义（P＜0.05）。结论 舒芬太尼和地佐辛均可有效预防瑞芬太尼麻醉后疼痛过敏，不影响苏醒时机，但舒芬太尼术后不良反应发生率更低，临床应用安全可靠。

Comparison of Sufentanil and Dezocine in Preventing Pain Allergy after Remifentanil Anesthesia

Objective To compare the efficacy of sufentanil and dezocine in preventing pain allergy and adverse reactions after remifentanil anesthesia. Methods 40 patients who underwent laparoscopic hysterectomy and total hysterectomy in our hospital from June 2017 to June 2019 were selected and randomly divided into a control group and an observation group, each with 20 cases. The control group was given dezocineto prevent pain allergy after remifentanil anesthesia after surgery. The observation group was given sufentanil to prevent pain and allergies after surgery. The two groups were compared for breathing recovery time, awake time, heart rate(HR) and average at extubation. Arterial pressure(MAP), different time periods [immediately after extubation(T1), 10 min after extubation (T2), 1 h after extubation (T3)] pain(VAS) score and clinical adverse reactions (nausea, vomiting, restlessness,cough).Results There was no significant difference in respiratory recovery time, awake time, HR and MAP at the time of extubation in the observation group compared with the control group (P>0.05). There was no significant difference in the VAS scores of the observation group at T1 and T2 periods compared with the control group(P>0.05); the VAS score at T3 was lower than the control group,the difference was statistically significant(P<0.05); the total incidence of adverse reactions in the observation group(20.00%) was lower than that in the control group (40.00%),the difference was statistically significant(P<0.05).Conclusion Both sufentanil and dezocine can effectively prevent pain and allergies after remifentanil anesthesia and do not affect the timing of wake-up. However, sufentanil has a lower incidence of postoperative adverse reactions and is safe and reliable in clinical application.