舒芬太尼防治瑞芬太尼复合麻醉术后急性疼痛.docVIP

舒芬太尼防治瑞芬太尼复合麻醉术后急性疼痛 　 作者：杨静，王威 ，张宏，米卫东 【关键词】 舒芬太尼；瑞芬太尼复合麻醉；镇痛 　　Application of sufentanil to prevent acute postoperative pain in remifentanilbased anaesthesia 　　【Abstract】 AIM: To investigate the postoperative analgesic effect of sufentanil used in remifentanilbased anaesthesia with isoflurane and propofol. METHODS: Ninety patients undergoing major abdominal surgery, thoracic surgery or spine surgery respectively (n=30 in each group) were randomly assigned to sufentanil group and fentanil+ lomoxicam group, which received intravenous instillation of sufentanil (0.5 μg/kg) and fentanil (1 μg/kg) +lomoxicam(8 mg) respectively 25 min before the end of the operation. Isoflurane was switched off 10 min before the end of surgery. And after skin closure, remifentanil and propofol were switched off. Time to resumption of spontaneous respiration, eye opening and extubation were recorded, and pain was evaluated and the number of the patients who needed the second dose of fentanil was recorded. RESULTS: There were no significant differences in the time to resumption of spontaneous respiration, eye opening and extubation between sufentanil group and fentanil+lomoxicam group. The patients having moderate to severe pain in sufentanil group was fewer than fentanil+ lomoxicam group (Plt;0.01). In sufentanil group fewer patients required a second dose of opioid (Plt;0.01), while more than 30% required a second dose of opioid after extubation in fentanil+ lomoxicam group. CONCLUSION: Intraoperative administration of sufentanil (0.5 μg/kg) 25 min before the end of the operation can provide immediate pain relief postoperativity without severe effects on recovery time in remifentanilbased anaesthesia. 　　【Keywords】 sufentanil; remifentanilbased anesthesia; analgesia 　　【摘要】 目的： 研究舒芬太尼（0.5 μg/kg）防治瑞芬太尼复合麻醉术后急性疼痛的临床疗效. 方法： 胸科、腹部和脊柱手术的患者90例（每类手术30例），随机分为芬太尼+可赛风组和舒芬太尼组，每组45例. 舒芬太尼组和芬太尼+可赛风组分别于手术结束前25 min静脉滴注舒芬太尼（0.5 μg/kg）或可赛风（8 mg）+芬太尼（1 μg/kg）. 所有患者在手术结束前10 min停止吸入异氟醚，手术结束时停止泵注异丙酚和瑞芬太尼. 比较