摘要
目的:研究盐酸丙帕他莫防治瑞芬太尼复合麻醉术后痛觉过敏的临床疗效。方法:妇科腹腔镜手术的患者40例,随机分为芬太尼组和盐酸丙帕他莫组,每组20例.芬太尼组(A组)和盐酸丙帕他莫(B组)分别于手术结束前20min静脉注射芬太尼1.5μg/kg和静脉滴注盐酸丙帕他莫2g,记录两组患者自主呼吸恢复、意识恢复和拔管时间,患者恢复期的疼痛程度和拔管后需要追加芬太尼的例数以及恶心、呕吐、寒战的发生率。结果:A组和B组患者的自主呼吸恢复时间、意识恢复时间、拔管时间在统计学上有显著性差异(P<0.05),恶心、呕吐、寒战的发生率在统计学上没有显著性差异(P>0.05),两组患者术后疼痛程度在统计学上没有显著性差异(P>0.05),患者拔管后需追加芬太尼的人数差异无统计学意义(P>0.05)。结论:手术结束前20min静脉用盐酸丙帕他莫2g能够有效防治妇科腹腔镜手术停止麻醉后因超短效阿片类药物瑞芬太尼的快速代谢而引起的术后痛觉过敏,并且不影响病人自主呼吸恢复和意识恢复。
Objective：To investigate the clinical effect of Propacetamol Hydrochloride to postoperative OIH in remifentanil-based anesthesia.Methods：Forty patients undergoing Gynecological Laparoscope surgery were randomly assigned to a Fentanyl group（A group）and a Propacetamol Hydrochloride group（B group）to receive Fentanyl 1.5μg/kg iv and Propacetamol Hydrochloride 2g ivdrip respectively 20min before the end of operation.The time to spontaneous breathing recovery,consciousness recovery and extubation were recorded.Pain was evaluated and the number of patients who needed a second dose of fentanyl was recorded and nausea,vomiting and chill incidence were recorded.Results：A group and B group of patients with spontaneous breathing recovery time,consciousness recovery time,extubation time,there is statistically significant difference（P0.05）,and the incidence of nausea,vomiting and chill,there is no statistically significant difference（P0.05）,and the extent of postoperative pain and the number of patients who needed a second dose of fentanyl,there is no statistically significant difference（P0.05）.Conclusion：Propacetamol Hydrochloride 2g ivdrip at 20min before the end of operation can effectively prevent and treat postoperative OIH of patients undergoing Gynecological Laparoscope surgery in remifentanil-based anesthesia.And there is no influence in spontaneous breathing recovery time,consciousness recovery time.
