舒芬太尼复合氟比洛芬酯预防悬雍垂腭咽成形术后苏醒期躁动的临床观察

Clinical Observation of Sufentanil Combined with Flurbiprofen Axetil to Prevent Restlessness During Recovery After Uvulopalatopharyngoplasty

目的分析舒芬太尼复合氟比洛芬酯预防悬雍垂腭咽成形术后苏醒期躁动的效果。方法在本院2019年3月-2021年6月收治的ASAⅠ-Ⅱ级行悬雍垂腭咽成形术治疗的患者中选出60例作为研究对象,通过随机表数字法将其分为舒芬太尼组(A组,n=20)、舒芬太尼复合氟比洛芬酯组(B组,n=20)和生理盐水组(C组,n=20),观察三组患者在术后不同时间点的Riker镇静-躁动评分(SAS)、视觉疼痛评分(VAS)以及Ramsay镇静评分(RSS)变化,同时比较三组患者拔管时间差异、自主呼吸恢复时间差异以及术后不良反应的发生情况。结果C组患者在T0时间点、T1时间点、T2时间点以及T3时间点的SAS评分明显高于A组和B组,RSS评分明显低于A组和B组,VAS评分明显高于A组和B组;A组患者在T0时间点、T1时间点、T2时间点以及T3时间点的SAS评分明显高于B组,RSS评分明显高于B组,VAS评分明显高于B组,差异均有统计学意义(P<0.05)。C组患者术后拔管时间以及自主呼吸恢复时间明显长于A组和B组,A组患者术后拔管时间以及自主呼吸恢复时间明显长于B组,差异均有统计学意义(P<0.05)。三组患者术后恶心呕吐不良反应发生率、呼吸抑制不良反应发生率以及嗜睡不良反应发生率比较差异均无统计学意义(P>0.05)。结论对于悬雍垂腭咽成形术患者,舒芬太尼复合氟比洛芬酯可以有效减轻其术后苏醒期躁动,不仅具有良好的镇痛镇静效果,可以帮助患者加快术后复苏,而且还具有良好的安全性,不会明显增加不良反应的发生。

Objective To analyze the effect of sufentanil combined with flurbiprofen axetil in preventing restlessness during recovery after uvulopalatopharyngoplasty.Methods A total of 60 patients with ASA I-II who underwent uvulopalatopharyngoplasty in our hospital from March 2019 to June 2021 were selected as research subjects,and they were divided into Shufen by random table number method.Tanil group(group A,n=20),sufentanil combined with flurbiprofen axetil group(group B,n=20)and normal saline group(group C,n=20).Changes in Riker sedation-agitation score(SAS),visual pain score(VAS)and Ramsay sedation score(RSS)at different time points after surgery.The differences in extubation time,spontaneous breathing recovery time and postoperative adverse reactions were compared between the two groups.Results At T0 time point,T1 time point,T2 time point and T3 time point,SAS score of group C was significantly higher than that of group A and B,RSS score was significantly lower than that of group A and B,VAS score was significantly higher than that of group A and B.The SAS score,RSS score and VAS score of group A were significantly higher than those of group B at T0,T1,T2 and T3,with statistical significance(P<0.05).The postoperative extubation time and recovery time of spontaneous breathing in group C were significantly longer than those in group A and GROUP B,and the postoperative extubation time and recovery time of spontaneous breathing in group A were significantly longer than those in group B,with statistically significant differences(P<0.05).There was no statistical significance in the incidence of postoperative adverse reactions of nausea and vomiting,respiratory inhibition and lethargy among 3 groups(P>0.05).Conclusion For uvulopalatopharyngoplasty patients,sufentanil combined with flurbiprofen ester can effectively reduce postoperative recovery agitation,not only has good analgesic and sedative effect,can help patients speed up postoperative recovery,but also has good safety,will not significantly increase the occurrence of adverse reactions.