丙帕他莫复合芬太尼在腹腔镜子宫肌瘤剔除术术后镇痛的疗效观察

Application of bingpatamo combined with fentanyl on postoperative analgesia for laparoscopic myomectomy

目的:探讨丙帕他莫复合芬太尼作为腹腔镜子宫肌瘤剔除术术后镇痛药的临床效果及安全性。方法:择期行腹腔镜子宫肌瘤剔除术的患者72例,ASA分级Ⅰ～Ⅱ级,随机分为A、B两组,每组各36例。A、B两组均于术毕前15 min给予芬太尼1μg.kg-1。术后镇痛泵配方:A组给予丙帕他莫2 mg+芬太尼8μg.kg-1+托烷司琼10 mg+0.9%生理盐水至100 ml,B组给予芬太尼16μg.kg-1+托烷司琼10 mg+0.9%生理盐水至100 ml,以2 ml.h-1速率连接静脉镇痛泵,单次剂量0.5 ml,锁定时间15 min;比较镇痛效果及不良反应。结果:两组在术后4、8、12、16、24、48 h镇痛、镇静效果及各项生命体征方面差异无统计学意义(P>0.05),但术后A组不良反应发生率和药物用量比B组少(P<0.05)。结论:丙帕他莫复合芬太尼用于腹腔镜子宫肌瘤剔除术术后镇痛效果明确、不良反应低,值得临床推广。

Objective： To investigate the efficiency and safety of bingpatamo combined with fentanyl on postoperative analgesia for laparoscopic myomectomy.Methods： Seventy-two patients with ASAⅠ-Ⅱwere selected and divided into two groups randomly.Loading dose of fentanyl（1 μg·kg-1） were given 15 min before end of the surgery of two groups.Formula of PCA： bingpatamo 2 mg,fentanyl 8 μg·kg-1 and tropisetron 10 mg were dissolved in 100 ml saline and applied to PCIA in group A;fentanyl 16 μg·kg-1 and tropisetron 10 mg were dissolved in 100 ml saline and applied to PCIA in group B,PCIA was administered with background infusion of 2 ml·h-1 and lockout time 15 minutes;Compared the analgesia and adverse reactions by ASA,BCS,Ramsay scores and adverse reactions.Results： There were no statistic differences in ASA,BCS,Ramsay scores and vital signs（P0.05）,however,the incidence of adverse reactions and comsumed dosage of drug in group A were lower than that in group B（P0.05）.Conclusion： The method of bingpatamo combined with fentanyl has a good postoperative analgesic effect and higher safety,and deserve to clinic.