舒芬太尼和曲马多用于超前镇痛临床对比观察

Clinical comparative observation of Sufentanil and Tramadol used for preemptive analgesia

目的旨在对比分析舒芬太尼和曲马多分别用于瑞芬太尼复合丙泊酚全麻超前镇痛的临床效果、安全性及意义。方法收集我院住院治疗的ASA为Ⅰ～Ⅱ级拟行下腹部手术的患者80例,随机分为舒芬太尼组和曲马多组,各40例,两组均采用瑞芬太尼复合丙泊酚全身麻醉并于手术结束前30 min分别注射舒芬太尼和曲马多。对比两组患者自主呼吸恢复的初始频率、停药至拔管时间、术后不同时间点镇痛、镇静评分及术后不良反应等情况。结果舒芬太尼组自主呼吸恢复初始频率明显少于曲马多组,差异有统计学意义(P<0.05),而停药至拔除气管插管时间对比差异无统计学意义;拔除气管插管后0、20、60、120 min舒芬太尼组镇痛评分(PHS)显著优于曲马多组(P<0.05),拔除气管插管后0、20 min舒芬太尼组镇静评分显著优于曲马多组(P<0.05);曲马多组出现恶心及呕吐症状患者显著多于舒芬太尼组(P<0.05)。结论舒芬太尼与曲马多均可较好地完成超前镇痛作用,舒芬太尼适用于无呼吸系统疾病患者,曲马多适用于老年患者。

Objective To compare the clinical effects,safety and significance of Sufentanil and Tramadol used for Propofol combined with Remifentanil preemptive analgesia.Methods 80 patients in our hospital who underwent lower abdomen operation（ASA Ⅰ-Ⅱ class） were collected and randomly divided into 40 cases of Sufentanil group and 40 cases of Tramadol group.Both groups were given Remifentanil combined with Propofol phenol general anesthesia and were injected Sufentanil and Tramadol before 30 min of the end of surgery respectively.The spontaneous breathing recovery initial frequency,stopping to extubation time,different postoperative time points analgesia,sedation scores and postoperative adverse events,and so on of the two groups were compared.Results The spontaneous breathing recovery initial frequency of Sufentanil group was significantly less than that in the Tramadol group（P0.05）,but the discontinuation to extubation intubation time was no significant of two groups.After extubation 0,20,60,120 min,the pain scores（PHS） of Sufentanil group were significantly better than those in the Tramadol group（P0.05）.Extubation after 0,20 min,the sedation score of Sufentanil group was significantly better than that in the Tramadol group（P0.05）;the patients who had nausea and vomiting in Tramadol group were significantly more than those in the Sufentanil group（P0.05）.Conclusion Both Sufentanil and Tramadol can complete preemptive analgesia,Sufentanil adopt to the patients who do not have respiratory diseases,Tramadol adopt to the older patients.