凯纷复合舒芬太尼在腹腔镜全宫切除术后镇痛的应用比较

目的探讨凯纷复合舒芬太尼在腹腔镜全宫切除术后镇痛的应用效果。方法将150例腹腔镜全宫切除术患者随机分为两组,每组75例,采用静脉自控镇痛,A组:凯纷复合舒芬太尼100 mg+0.04μg/(kg·h);B组:凯纷复合喷他佐辛100 mg+0.04 mg/(kg·h);所用药物为等浓度且用生理盐水稀释至100 ml。观察和记录术后第1、2、4、8、16及24小时的静息疼痛及动态疼痛的VAS评分、Ramesay镇静评分、PCA泵的按压次数(D0)及实际有效次数(D1)、改良Bromage分级及恶心、呕吐等不良反应的发生情况。结果两组患者均有良好的静态疼痛镇痛效果,两组患者24 h内各时点的动态疼痛评分,在第8、16及24小时差异具有统计学意义,A组在2~4 h,4~8 h,8~16 h时间段的PCA泵的按压次数及实际有效次数均明显少于B组,差异具有统计学意义(P0.05);两组的Ramesay评分、改良Bromage分级及恶心、呕吐、皮肤瘙痒、嗜睡等不良情况的发生率差异无统计学意义(P0.05)。结论凯纷复合舒芬太尼、凯纷复合喷他佐辛均可减轻腹腔镜全子宫切除术后疼痛及不良反应的发生,但凯纷复合舒芬太尼在同等浓度下在动态疼痛的镇痛效果更佳。

Clinical application of flurbiprofen in combination with sufentanil in total laparoscopic hysterectomy postoperative analgesia

Objective To study the clicnical effects of sufentanil combined with flurbiprofen with postoperative analgesia on the patients after total laparoscopic hysterectomy. Methods 150 patients undergoing total laparoscopic hysterectomy postoperative with intravenous self-control analgesia were randomly divided into two groups（each group of 75 cases）. Patients in group A were treated with flurbiprofen in combination with fufentanil, while patients in group B were treated with flurbiprofen in combination with pentazocine, in the same concentration. The static pain and dynamic pain VAS score, ramesay sedation score,number of PCA pump pressure（D0）, the actual number of valid（D1）, modified Bromage classification and the occurrence of adverse reactions such as nausea, vomiting of postoperative 1 h, 2 h, 4 h, 8 h, 16 h and 24 h, were observe and record.Results Patients in the two groups showed good static pain analgesia effects, and dynamic pain scores in 8 h, 16 h and 24 h after treatment exhibited significant differences between the patients in the two groups. Levels of D0 and D1in 2-4 h, 4-8 h and 8-16 h period of group A were significantly less than those in group B（P〈0.05）. But ramesay score, modified Bromage grading and the incidence of adverse conditions including nausea, vomiting, itching and sleepiness in two groups revealed no statistically significant difference（P〉0.05）. Conclusion Treatments with flurbiprofen plus fufentani or flurbiprofen plus pentazocine can both relieve pain after laparoscopic total hysterectomy and the occurrence of adverse reactions. Our results further demonstrated flurbiprofen in combination with fufentani possessed a more analgesic effect on dynamic pain than flurbiprofen in combination with pentazocine.