中国医学创新目次舒芬太尼预防瑞芬太尼麻醉后早期疼痛的临床疗效(1)
【摘要】 目的：探讨舒芬太尼在瑞芬太尼麻醉后早期疼痛的预防作用。方法：选取本院2012年3月-2014年3月收治的84例行腹式全子宫切除手术的患者为研究对象，所有患者均行瑞芬太尼麻醉，随机分为观察组和对照组，每组各42例。观察组行舒芬太尼预防瑞芬太尼麻醉后早期疼痛，对照组行芬太尼预防瑞芬太尼麻醉后早期疼痛，对两组患者术后疼痛情况进行分析。结果：两组患者意识恢复时间及拔管时间、自主呼吸恢复时间比较差异均无统计学意义(P>0.05)；观察组不良反应发生率为4.76%，明显低于对照组的21.43%，差异有统计学意义(P<0.05)；观察组拔管后口述疼痛评分及术后不同时点VAS值均明显低于对照组，差异有统计学意义(P<0.05)。结论：舒芬太尼安全性高，镇痛效果显著高于芬太尼，无明显呼吸抑制，可减少不良反应发生，有效对瑞芬太尼麻醉后早期疼痛进行预防，值得临床进一步推广使用。
【关键词】 舒芬太尼； 瑞芬太尼； 麻醉
【Abstract】 Objective：To discuss the prevention effect of Sufentanil on the early hurt after the Remifentanil anesthesia.Method：84 patients who were conducted the abdominal hysterectomy treatment were selected in our hospital from March 2012 to March 2014 as the research objects，and were randomly divided into the control group and the observation group，42 cases in each group.In the observation group，they were treated with the Sufentanil to prevent the early hurt after the Remifentanil anesthesia，while in the control group，they were treated with the Fentanyl to prevent the early hurt after the Remifentanil anesthesia.Then，the hurt situations after surgeries of two groups of patients were analyzed.Result：The consciousness recovery time，extubation time and the independent breathe recovery time of two groups had no statistically significant difference(P>0.05).The occurrence rate of the adverse reactions in the observation group was 4.76%，which was evidently lower than the control group of 21.43%，the difference was the statistically significant(P<0.05).The oral pain score after the extubation and the VAS score in different periods after surgeries in the observation group were evidently lower than that in the control group，the difference were statistically significant(P<0.05).Conclusion：Sufentanil has higher safety，the analgesia effect is evidently higher than Fentanyl.There is no evident respiratory depression and can decrease the occurrence of the adverse reactions.It can effectively prevent the early hurt after the Remifentanil anesthesia.Thus，it should be promoted in the clinic applications.
, http://www.100md.com
【Key words】 Sufentanil； Remifentanil； Anesthesia
First-author’s address：People’s Hospital of Dongguan，Dongguan 523000，China
doi：10.3969/j.issn.1674-4985.2015.17.020
复式全子宫切除术为常用的子宫切除术术式，是对妇科严重病变进行治疗的有效措施。近年来，随着外科手术及麻醉技术的不断发展，使手术安全性不断增高，但是行复式全子宫切除术，术后早期疼痛依然是临床关注的焦点。提高手术安全性，降低术后早期疼痛强度，是麻醉科研究的主要方向。瑞芬太尼是一种新合成阿片类药物，具有清除快、起效快、长时间输注无蓄积的特点，在临床上广泛应用，但是其代谢速度快，在手术结束后，麻醉的镇痛效果快速消失，会导致患者术后出现严重的疼痛感，甚至会出现痛觉过敏、起痛阀降低等状况[1]。在早期感觉疼痛后，临床处理难度大，作早期的预防，是有效措施，舒芬太尼有显著的镇痛作用，其镇痛强度为芬太尼5～10倍，对血流动力学影响小、起效快，呼吸抑制较轻微，安全性高，是临床上对瑞芬太尼麻醉后早期疼痛进行预防的首选药物。本组研究对瑞芬太尼麻醉后早期疼痛患者实施舒芬太尼预防，效果满意，报告如下。, http://www.100md.com(陈惠英)
【关键词】 舒芬太尼； 瑞芬太尼； 麻醉
【Abstract】 Objective：To discuss the prevention effect of Sufentanil on the early hurt after the Remifentanil anesthesia.Method：84 patients who were conducted the abdominal hysterectomy treatment were selected in our hospital from March 2012 to March 2014 as the research objects，and were randomly divided into the control group and the observation group，42 cases in each group.In the observation group，they were treated with the Sufentanil to prevent the early hurt after the Remifentanil anesthesia，while in the control group，they were treated with the Fentanyl to prevent the early hurt after the Remifentanil anesthesia.Then，the hurt situations after surgeries of two groups of patients were analyzed.Result：The consciousness recovery time，extubation time and the independent breathe recovery time of two groups had no statistically significant difference(P>0.05).The occurrence rate of the adverse reactions in the observation group was 4.76%，which was evidently lower than the control group of 21.43%，the difference was the statistically significant(P<0.05).The oral pain score after the extubation and the VAS score in different periods after surgeries in the observation group were evidently lower than that in the control group，the difference were statistically significant(P<0.05).Conclusion：Sufentanil has higher safety，the analgesia effect is evidently higher than Fentanyl.There is no evident respiratory depression and can decrease the occurrence of the adverse reactions.It can effectively prevent the early hurt after the Remifentanil anesthesia.Thus，it should be promoted in the clinic applications.
, http://www.100md.com
【Key words】 Sufentanil； Remifentanil； Anesthesia
First-author’s address：People’s Hospital of Dongguan，Dongguan 523000，China
doi：10.3969/j.issn.1674-4985.2015.17.020
复式全子宫切除术为常用的子宫切除术术式，是对妇科严重病变进行治疗的有效措施。近年来，随着外科手术及麻醉技术的不断发展，使手术安全性不断增高，但是行复式全子宫切除术，术后早期疼痛依然是临床关注的焦点。提高手术安全性，降低术后早期疼痛强度，是麻醉科研究的主要方向。瑞芬太尼是一种新合成阿片类药物，具有清除快、起效快、长时间输注无蓄积的特点，在临床上广泛应用，但是其代谢速度快，在手术结束后，麻醉的镇痛效果快速消失，会导致患者术后出现严重的疼痛感，甚至会出现痛觉过敏、起痛阀降低等状况[1]。在早期感觉疼痛后，临床处理难度大，作早期的预防，是有效措施，舒芬太尼有显著的镇痛作用，其镇痛强度为芬太尼5～10倍，对血流动力学影响小、起效快，呼吸抑制较轻微，安全性高，是临床上对瑞芬太尼麻醉后早期疼痛进行预防的首选药物。本组研究对瑞芬太尼麻醉后早期疼痛患者实施舒芬太尼预防，效果满意，报告如下。, http://www.100md.com(陈惠英)