临床普外科电子杂志 ›› 2024, Vol. 12 ›› Issue (1): 54-.

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舒芬太尼预防腹腔镜阑尾切除术停用瑞芬太尼暴发痛的探讨

  

  1. 1. 同济大学附属东方医院胶州医院 麻醉科,山东 青岛 266300;2. 胶州市中医医院 麻醉科,山东 青岛 266300; 3. 同济大学附属东方医院胶州医院 胃肠外科,山东 青岛 266300
  • 出版日期:2024-01-01 发布日期:2024-04-16

Exploration of using sufentanil to prevent breakthrough pain after discontinuing remifentanil in laparoscopic appendectomy

  1. 1.Anesthesiology Department of Tongji University Affiliated Dongfang Hospital Jiaozhou Hospital, Shandong Qingdao 266300, China; 2.Anesthesiology Department of Jiaozhou Traditional Chinese Medicine Hospital, Shandong Qingdao 266300, China; 3. Gastrointestinal Surgery of Tongji University Affiliated Dongfang Hospital Jiaozhou Hospital, Shandong Qingdao 266300, China
  • Online:2024-01-01 Published:2024-04-16

摘要:

目的 探讨舒芬太尼预防腹腔镜阑尾切除术停用瑞芬太尼暴发痛的效果。方法 选取2022 年11 月至2023 年5 月在同济大学附属东方医院胶州医院进行腹腔镜阑尾切除术并应用瑞芬太尼麻醉的患者70 例,采用随机抽样的方式分为两组,每组35 例,研究组和对照组采用不同的药物进行瑞芬太尼麻醉后暴发痛的预防。研究组患者缝皮前30min 给予静脉注射舒芬太尼0.1mg/kg,对照组给予静脉注射相同剂量生理盐水。观察两组患者术后5min(T1)、15min(T2)、30min(T3) 的脉搏氧饱和度(oxygen saturation,SpO2)、心率、收缩压、舒张压及疼痛评分,记录两组患者术后恶心、呕吐、烦躁等并发症情况。结果 研究组T1、T2、T3 时疼痛评分显著低于对照组,且心率、收缩压、舒张压水平显著低于对照组,差异均有显著性(P < 0.05)。两组各时点SpO2 水平差异无显著性(P > 0.05),且术后恶心、呕吐、烦躁、呼吸抑制等并发症差异无显著性(P > 0.05)。结论 手术结束前30min 时静脉注射0.1mg/kg 舒芬太尼能够有效预防瑞芬太尼麻醉后的术后暴发痛,镇痛效果较好且不影响苏醒质量。

关键词: 腹腔镜, 舒芬太尼, 瑞芬太尼, 暴发痛

Abstract:

Objective To explore the preventive effect of sufentanil on breakthrough pain after discontinuation of remifentanil in laparoscopic appendectomy. Method Seventy patients who underwent laparoscopic appendectomy and received remifentanil anesthesia at Jiaozhou Hospital Affiliated to Tongji University from November 2022 to May 2023 were selected. They were randomly divided into two groups, with 35 patients in each group. The study group and the control group were treated with different drugs to prevent breakthrough pain after remifentanil anesthesia. The study group received intravenous injection of 0.1mg/kg sufentanil 30 minutes

before skin suture, while the control group received intravenous injection of the same dose of physiological saline. Observe the pulse oxygen saturation (SpO2), heart rate, systolic blood pressure, diastolic blood pressure, and pain score of two groups of patients 5 minutes (T1), 15 minutes (T2), and 30 minutes (T3) after surgery, and record the postoperative complications such as nausea, vomiting, and irritability in both groups of patients. Result The pain scores of the study group at T1, T2, and T3 were significantly lower than those of the control group, while the heart rate, systolic blood pressure, and diastolic blood pressure were significantly lower than those of the control group, with significant differences (P < 0.05). There was no significant difference in SpO2 levels between the two groups at different time points (P > 0.05), and there was no significant difference in postoperative complications such as nausea, vomiting, irritability, and respiratory depression (P > 0.05). Conclusion Intravenous injection of

0.1mg/kg sufentanil 30 minutes before the end of surgery can effectively prevent postoperative breakthrough pain after remifentanil anesthesia, with good analgesic effect and no impact on awakening quality.

Key words: Laparoscope, Sufentanil, Remifentanil, Breakthrough pain