舒芬太尼用于腹腔镜胆囊切除术术后单次镇痛效果的评估

目的评估舒芬太尼单次镇痛用于腹腔镜胆囊切除术术后镇痛的效果及最佳用药剂量。方法选择择期行腹腔镜胆囊切除术患者40例,年龄25～56岁,体重55～80kg,ASAⅠ～Ⅱ,随机分为4组(n=10),即对照组(A组)、0.1μg/kg组(B组)、0.15μg/kg组(C组)及0.2μg/kg组(D组)。用咪达唑仑、芬太尼、异丙酚和罗库溴铵进行麻醉诱导;用异丙酚和瑞芬太尼进行麻醉维持。术毕,记录患者自主呼吸恢复时间、苏醒时间和拔管时间。术后选取5个时间点:0、2、4、8、24h,记录各时间点的VAS评分、Prince-Henry评分、镇静评分、不良反应的发生情况以及是否追加镇痛药等。结果 D组较其它三组的苏醒时间明显延长(P0.01)。C、D两组的镇痛效果优于A、B两组,差异有统计学意义(P0.01)。D组与A、B两组镇静评分的差异有统计学意义(P0.01)。四组不良反应发生情况的差异无统计学意义(P0.05)。镇痛药的追加,D组与A、B两组的差异有统计学意义(P0.05)。结论舒芬太尼单次剂量为0.15μg/kg和0.2μg/kg时,用于腹腔镜胆囊切除术术后镇痛可取得满意的镇痛效果,且0.15μg/kg为舒芬太尼单次镇痛的最佳剂量。

Evaluation on Postoperative Analgesia with Sufentanil Given Single Dose in Patients Undergoing Laparoscopic Cholecystectomy

Objective To evaluate the postoperatively analgesic effect and appropriate dosage of sufentanil using single dose in patients undergoing laparoscopic cholecystectomy （LC）.Methods Forty patients aged between 25 and 56 years,weighing 55～80 kg,ASAⅠ～Ⅱ,undergoing LC were randomly divided into four groups （each n=10）：control group （group A）,0.1 μg/kg group （group B）,0.15 μg/kg group （group C）,and 0.2 μg/kg group （group D）.Anesthesia was induced with midazolam,fentanyl,propofol,rocuronium and maintained with propofol,remifentanil.At the end of surgery,the breath-recovery time,the analepsia time and the extubation time were recorded.Postoperative analgesia was assessed by VAS and Prince-Henry at 0,2,4,8,24 hrs after operation;meanwhile,sedation scores,the lasting time of analgesia,side effect and the analgesic requirements were recorded.Results The analgesia time of group D was much longer than those of other three groups （P〈0.01）.There was a statistically significant difference in VAS and Prince-Henry between groups C,D and groups A,B （P〈0.01）.Compared with groups A,B,group D showed a significant difference in sedation scores （P〈0.01）.No statistically significant difference was found in side effects among the four groups （P〉0.05）.There were statistically significant differences in analgesic requirements between group D and groups A,B （P〈0.05）.Conclusions 0.15 μg/kg or 0.2 μg/kg sufentanil can significantly relieve postoperative pain in patients undergoing LC,and the analgesia dosage of sufentanil 0.15μg/kg will be more appropriate.