丙帕他莫复合舒芬太尼用于妇科腹腔镜术后静脉自控镇痛的效果

Effect of propacetamol combined with sufentanil for patient-controlled intravenous analgesia after gynecological laparoscopic operation

目的观察丙帕他莫复合舒芬太尼用于妇科腹腔镜术后静脉自控镇痛(PCIA)的镇痛效果及安全性。方法 60例ASAⅠ或Ⅱ级择期行妇科腹腔镜手术患者,随机均分为两组:丙帕他莫复合舒芬太尼组(PS组):丙帕他莫8 g+舒芬太尼1μg/kg+生理盐水总量100 ml;舒芬太尼组(S组):舒芬太尼2μg/kg+生理盐水总量100 ml。两组镇痛液负荷量5 ml,PCIA镇痛泵维持量2ml/h,追加量0.5 ml,锁定时间15 min。记录术后4、8、12、24和48 h疼痛VAS评分、镇静Ramsay评分及镇痛期间不良反应发生率。结果 PS组与S组术后各时点VAS评分均<2分,两组间差异无统计学意义;S组术后4、8、12 h Ramsay评分明显高于PS组(P<0.05)。镇痛期间不良反应发生率PS组低于S组(P<0.05)。结论丙帕他莫复合舒芬太尼用于妇科腹腔镜术后PCIA镇痛效果确切,不良反应发生率低。

Objective To observe the analgesic efficacy and safety of propacetamol combined with sufentanil for patient-controlled intravenous analgesia （PCIA） after gynecological laparoscopic operation. Methods Sixty ASA Ⅰ or Ⅱ patients undergoing gynecological laparoscopic operation were randomized into one the two groups： the sufentanil group （group S） and the propacetamol plus sufentanil group （group PS）. The PCIA composition was as follows： the group S, 9μg/kg sufentanil in 100 ml saline; the group PS, 8 g propacetamol and 1μg/kg sufentanil in 10b ml saline; both groups had the loading dose 5 ml, the infusion rate 2 ml/h, bolus dose 0. 5 ml, and lockout time 15 min. Visual analog score （VAS） of pain and Ramsay sedation score were measured at 4, 8, 12, 24 and 48 h during the analgesia. The side effects were recorded. Results In the two groups, the analgesia scorings were all less than 2 at each time points but without significant difference between the two groups. The Ramsay scores in the group S were significantly higher than the group PS at 4, 8 and 12 h （P-〈0. 05）. The incidence of side effects was lower in the group PS than the comparison （P〈〈 0.05）. Conclusion Propacetamol combined with sufentanil produces effective analgesia in patients after gynecological laparoscopic operation with less side effects.