摘要
目的比较老年食管癌根治术患者不同浓度舒芬太尼自控静脉镇痛的效果。方法择期行食管中、下段癌根治术患者60例,随机分为SF1组、SF2组和芬太尼对照组(F组),每组20例。3组采用相同的麻醉诱导和维持方案,术后行患者自控静脉镇痛(PCIA),镇痛泵配置方案分别为舒芬太尼1.5μg/kg、舒芬太尼2μg/kg、芬太尼20μg/kg。记录术后4h(T0)、8h(T1)、24h(T2)、48h(T3)时平均动脉压(MAP)、心率(HR)、呼吸频率(RR)、脉搏血氧饱和度(SpO2)、Ramsay评分、静息及咳嗽时的VAS评分,记录术后芬太尼追加情况、PCIA按压次数及患者镇痛总体满意度评分,随访术后不良反应发生情况。结果 3组不同时点静息及咳嗽时VAS评分、患者镇痛总体满意度评分、有效及无效按压次数、追加芬太尼的例数组间比较均无显著性差异(P>0.05);与SF1组比较,SF2组T0、T1时Ramsay评分较高,F组T0、T1时点RR降低(P<0.05);F组出现恶心、呕吐的例数多于SF1组(P<0.05);3组头晕、皮肤瘙痒、呼吸抑制的例数组间比较无显著性差异(P>0.05)。结论舒芬太尼1.5μg/kg用于老年食管癌根治术患者术后PCIA,镇痛效果满意,不良反应少,更为安全有效。
Objective To compare the analgesic effects of different dosage of sufentanil for patient-controlled intravenous analgesia in elder patients undergoing esophagectomy.Methods Sixty patients undergoing esophagectomy were randomly divided into 3 groups（n=20 each）：sufentanil group 1（SF1）,sufentanil group 2（SF2） and fentanyl group（F）.Group SF1,SF2,F were given sufentanil 1.5 μg/kg,sufentanil 2 μg/kg and fentanyl 20 μg/kg in 100 ml normal saline respectively.The induction and maintenance of anesthesia were applied with the same procedure in all groups.MAP,HR,RR,SpO2,Ramsay sedation scores,VAS scores at rest and while coughing were recorded at 4 h（T0）、8 h（T1）、24 h（T2）、48 h（T3） at the end of operation.Demands of fentanyl,PCIA button pressing times and the scores of satisfaction of postoperative analgesia were recorded.Opioid-related side effects were also evaluated.Results There was no significant differences in the scores of satisfaction for postoperative analgesia,PCIA button pressing times,VAS scores at rest and while coughing in all groups（P 0.05）.Ramsay sedation scores were higher in group SF2 than those in group SF1 at T0,T1（P 0.05）.RR was lower in group F than that in group SF1 at T0,T1（P 0.05）.The occurrence of nausea and vomiting was higher in group F than that in group SF1（P 0.05）.The frequency of respiratory depression,dizziness,itching,uroschesis was low and similar in all groups（P 0.05）.Conclusion Sufentanil 1.5 μg/kg for postoperative analgesia in patients undergoing esophagectomy is effective and safe with few side effects.
出处
《北京医学》
CAS
2011年第8期656-659,共4页
Beijing Medical Journal
