雷米芬太尼麻醉对胃癌病人术后镇痛的影响

目的评价雷米芬太尼麻醉对胃癌病人术后镇痛的影响。方法选择拟全身麻醉下胃癌根治手术病人60例，随机分为七氟烷静吸复合全麻（S组）和雷米芬太尼、丙泊酚全凭静脉麻醉（R组）两组，每组30例。病人在麻醉恢复室停留1h，并进行术后镇痛，采用视觉模拟评分法WAS）评价疼痛程度．当VAS评分i〉3分时开始静脉注射舒芬太尼0．1ug／kg，10min后可重复，直至VAS评分≤2分，接静脉镇痛泵。记录患者术后48h的VAS评分；计算术后1h舒芬太尼用量、术后镇痛1～48h内有效按压次数和镇痛药消耗总量：同时观察恶心、呕吐和术后烦躁的发生情况。结果与S组比较，R组在术后0．25h、0．5hVAS评分升高，术后1h舒芬太尼用量增加，差异均有统计学意义（t分别=8．16、7．09、8．89，P均〈0．05），R组在术后1h内舒芬太尼用量明显高于增加S组，差异有统计学意义（t=8．89，P〈0．05）；而术后1-48h内有效按压次数和镇痛药消耗总量比较，差异均无统计学意义（t分别=0．66、0．50，P均〉0．05）。结论雷米芬太尼、丙泊酚全凭静脉麻醉进行手术患者在术后1h内存在痛觉过敏现象，术后应及时、足量的应用阿片类药物或其它方法来预防和处理。

Effects of remifentanil anesthesia on postoperative analgesia in patients with gastric cancer

Objective To evaluate remifentanil anesthesia on postoperative analgesia in patients with gastric cancer. Methods Sixty patients who had radical surgery for gastric cancer were randomly divided into sevoflurane inhalation anesthesia group (S group,30 cases) and remifentanil,propofol wide with intravenous anesthesia group (R group,30 cases). All cases were given postoperative analgesia while staying in the anesthesia recovery room after operation. Visual analogue scales (VAS) were applied to assess the level...