高血压患者术后舒芬太尼静脉镇痛的疗效观察

Postoperative paregoric effects of sulfentanil in patients complicated with light or midrange hypertension

目的:观察舒芬太尼用于高血压患者术后静脉镇痛的效应。方法:合并轻中度高血压病择期手术患者30例,全麻手术后随机分为对照(C)组、舒芬太尼镇痛(S)组和芬太尼镇痛(F)组,各10例。分别记录三组手术前(T0)、术毕气管拔管后10 min(T1)、术后1 h(T2)6、h(T3)2、4 h(T4)4、8 h(T5)各时点的HR、BP、SpO2的变化以及视觉模糊评分(VAS)和镇静评分。观察三组术后追加镇痛药的次数,术后降压药应用的情况,以及恶心、呕吐和呼吸抑制的发生率。结果:S和F组各时段VAS评分均低于C组,S组评分<3分多于F组;镇静评分达2分者S组>F组>C组。T2、T3时点S组HR、BP低于F组和C组,有显著性差异P<0.05。术后S组血流动力学稳定,C组术后应用佩尔地平降压者超过60%,F组应用降压药者占30%。C组全部(10例)需要间断注射哌替啶镇痛,F组需要追加镇痛药有2例,S组无追加镇痛药者。结论:舒芬太尼和芬太尼均能有效控制高血压患者术后疼痛,而舒芬太尼镇痛、镇静效果优于芬太尼,能有效地保持其术后血流动力学的稳定,故为高血压患者术后安全、有效的镇痛剂。

Objective： Postoperative paregoric effects in patients complicated with light or midrange hypertension were observed after intravenous injections of sufentanil. Methods： Thirty patients complicated with light or midrange hypertension disease, chose from selective operation using general anaesthesia, were evenly distributed to 3 different groups, which were control （C） group, sulfentanil （S） group and fentanil （F） group. HR, BP, SpOt, visual ambiguity score （VAS） and conscious-sedation score were recorded at preoperation （T0）, 10min after airtube extubating （T1） and postop, 1h （T2）, 6h （T3）, 24h （T4）, 48h （T5）. To observe the number of the painkiller boost , the using of the underpressure drug and the incidence rate of nausea, emesia or respiratory depression. Results.. VAS scores in group S and F were both lower to group C, its number of the score〈3 in group S exceeded to group F; the numbers which the conscious-sedation score reached 2 were of group S〉f〉C; In post operation, the haemodynamics was stable in group S, but more than 60% patients in group C need using perdipine, and there were 30% patients using it in group F. All paticnts of group C need using meperidine, two patients need it in group F, but no patient heed it in group S. Conclusion： Both sulfentanil and fentanil can effectively mitigate pain after operation, but sulfentanil is more excellent than fentanil, and can effectively control intense change in hemodynamic so sulfentanil is safe and effective to hypertension patients after operation.