芬太尼及曲马多用于全麻苏醒期临床观察.docVIP

芬太尼及曲马多用于全麻苏醒期临床观察【摘要】 目的 探讨芬太尼和曲马多用于全麻患者苏醒期的临床效果。方法 选择全麻下行择期手术的ASA Ⅰ～Ⅱ级成年患者80例，随机均分为芬太尼组（F组）和曲马多组（T组）。两组患者术毕前30 min分别给予静脉注射芬太尼1 μg/kg和曲马多2 mg/kg。记录两组患者拔管后5 min的呼吸频率、麻醉时间、自主呼吸恢复时间、拔管时间、OAA/S评分、拔管后20 min VAS评分和不良反应。结果 两组患者自主呼吸恢复时间、拔管时间、清醒时间、拔管后20 min的VAS评分的差异均无统计学意义（?P?0.05）。两组患者均未发生皮肤瘙痒和恶心呕吐，躁动，差异无统计学意义（?P?0.05）。F组的呼吸抑制发生率为15%，与T组比较无统计学意义。结论 曲马多用于全麻苏醒期镇痛和芬太尼具有相同疗效，不良反应少，苏醒平稳。? 【关键词】 芬太尼； 曲马多； 全麻苏醒期?? Clinical observation of fentanyl and tramadol in the early recovery period after general anesthesia ?ZHU Hong. Hanyang Hospital Affiliated to Wuhan University of Science and Technology, Wuhan 430050, China?? 【Abstract】 Objective To explore the effects of fentanyl and tramadol on restlessness during consciousness phase after general anesthesia.Methods Eighty of ASA Ⅰ or Ⅱ adult patients under-going selective surgery were randomly assigned to receive intravenous injection of 1 μg/kg fentanyl(group F) and 2 mg/kg tramadol(group T) 30 minutes before the end of the operation. The extubation in patients after 5 minutes respiratory frequency, duration of anesthesia, spontaneous respiratory recovery time, extubation time, level evaluated by OAA/S, pain level evaluated by Visual Analogue Scale(VAS) within 20 minutes after extubation time and adverse reactions were recorded.Results No significant differences in spontaneous respiratory recovery time, extubation time, wake-up time and VAS values within 20 minutes after extubation were found between the two groups(?P?0.05). Two groups of patients had no pruritus and nausea and vomiting occurred, no significant difference in agitation(?P?0.05).Group F has 15% incidence of respiratory depression, it is no statistically significant compared with groupT.Conclusion Tramadol used for general anesthesia and fentanyl analgesia has the same efficacy, few adverse reactions, steady wake.? 【Key words】 Fentanyl; Tramadol; General anesthesia ? 全麻后患者常可较快唤醒，但也可出现意识模糊、嗜睡、定向障碍及躁动不安等脑功能障碍表现。通常全麻患者意识恢复后，大脑高级中枢的功能仍未全面恢复，因此影响患者对感觉的反应和处理