【摘要】 目的比较舒芬太尼和曲马多两种药物在减轻以瑞芬太尼/丙泊酚进行全凭静脉麻的腹腔镜胆囊切除术患者术后早期疼痛的效果及安全性。方法40名患者随机分为舒芬太尼组(S组)和曲马多组(T组),每组20例。手术结束前20分钟,S组静注舒芬太尼0.15μg/kg,T组静注曲马多1.5mg/kg。患者再次出现中等程度疼痛时追加曲马多1.5mg/kg。记录并比较两组心率(HR)、平均动脉压(MAP)、苏醒后的镇痛评分(VRS)和镇静评分(SS)、苏醒时间和不良事件发生例数。结果S组患者拔管时及拔管后5分钟心率、苏醒后5分钟和10分钟的VRS评分较T组显著降低(P<0.05);两组的血压、镇静评分、苏醒时间相近(P>0.05),不良事件发生例数无明显差异。结论舒芬太尼在术后早期镇痛中的效果较曲马多更佳,并可有效控制麻醉苏醒期的心率,适合应用于以短效药物瑞芬太尼复合丙泊酚进行全凭静脉麻醉的腹腔镜胆囊切除术。更多还原

【Abstract】 objective To compare the suppressive effects of sufentanil and tramadol on postoperative hyperalgesia after remifentanil-based anaesthesia. Methods A total number of forty ASAⅠ～ Ⅱadult patients who undergone the operation of laparoscopic cholecystectomy(LC) were assigned to two groups randomly:sufentanil group(Group S) and tramadol group (Group T). 20 minutes before the end of surgery the patients received either a bolus of 0.15μg/kg sufentanil (Group S) or 1.5mg/kg tramadol (Group T). The heart rate, blood pressure, four-level verbal rating scale, sedation score(SS), recovery time and adverse drug reactions were evaluated. Results A significant decrease of HR at extubation and 5 minutes later and the VRS values at 5 and 10 minutes after awakening were found in Group S comparison with Group T(P<0.05). There was no significant difference in blood pressure, sedation score, recovery time and the adverse drug reaction between two groups. Conclusion Sufentanil provides more effective transition analgesia in comparison with tramadol, and is also efficacious in controlling the HR at awakening from anesthesia.更多还原