舒芬太尼预防性镇痛对胆囊切除术患者应激反应及负性情绪的影响

The impact of stress reaction and negative emotions of sufentanil preventive analgesia for patients with cholecystectomy

目的探讨舒芬太尼预防性镇痛对胆囊切除术患者应激反应及负性情绪的影响。方法选择2014年5月~2015年4月行胆囊切除术患者108例为研究对象,采用随机数字表法分为观察组和对照组各54例,观察组采用舒芬太尼预防性镇痛,对照组采用芬太尼预防性镇痛,比较两组患者应激反应、疼痛程度、负性情绪、不良反应等指标。结果诱导后10min(T1)、气腹30min(T2)、术毕30min(T3),观察组血清肾上腺素(E)、去甲肾上腺素(NE)、皮质醇(Cor)含量均明显低于对照组(P<0.05或P<0.001);术后48小时内各个时间点,观察组疼痛视觉模拟评分(VAS)评分均明显低于对照组(P<0.001);术后48小时,焦虑自评量表(SAS)、抑郁自评量表(SDS)评分均明显低于对照组(P<0.001);两组恶心呕吐等不良反应比较差异无统计学意义(9.26%vs 12.96%)(P>0.05)。结论舒芬太尼预防性镇痛有助于缓解胆囊切除术患者焦虑、抑郁情绪,可能与降低胆囊切除术患者术中应激反应、减轻术后疼痛等因素有关。

Objective To study effect stress reaction and negative emotions of sufentanil preventive analgesia for patients with cholecystectomy. Methods 108 cases patients with cholecystectomy from May 2014 to April 2015 were divided into observation group and control group,the observation group given sufentanil preventive analgesia,the control group given fentanyl preventive analgesia,then stress reaction,pain,negative emotions,adverse reactions were compared between two groups. Result 10 min after induction（T1）,30 min pneumoperitoneum（T2）,30 min after surgery（T3）,the observation group E,NE,Cor of serum were significantly lower than the control group（P〈0.001）;48h after surgery,the observation group VAS score were significantly lower than control group（P〈0.05,P〈0.001）;48h after surgery,the observation group SAS、SDS score were significantly lower than control group P〈0.001）;there were no statistical differences of adverse reactions between two groups（9.26% vs 12.96%）（P〈0.05）. ConclusionSufentanil preventive analgesia help to ease anxiety,depression emotions of patients with cholecystectomy,May be related to lower stress reaction,reduce postoperative pain.