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目的:观察不同浓度的舒芬太尼用于卵巢癌切除术后静脉自控镇痛的效果和不良反应。方法:选择2009年6月~2012年3月择期手术的经腹卵巢切除术的患者96例(全部为硬膜外麻醉,ASIⅠ~Ⅱ级)。术后行静脉自控镇痛。随机分为4组,使用0.5μg/ml、0.75μg/ml舒芬太尼、1.25μg/ml、1.75μg/ml舒芬太尼进行自控镇痛。镇痛的基础剂量为4 ml/h,自控药量为2 ml/h,锁定时间为20 min。观察各组镇痛效果、追加镇痛使用次数、不良情况和其他镇痛药物使用情况。结果:1.25μg/ml、1.75μg/ml组16 h后其疼痛缓解效果较0.5μg/ml、0.75μg/ml组好,16 h和24 h时间点的时候1.25μg/ml组镇痛效果明显好于0.5μg/ml、0.75μg/ml组,24 h和48 h时间点1.75μg/ml组的VAS要明显低于1.25μg/ml组,4组均有不同程度的副反应,但是无低血压、呼吸减弱等严重副反应。结论:卵巢癌手术后给予舒芬太尼静脉自控镇痛药物浓度为1.25μg/ml,流速2 ml/h,持续20 min可能会是一个对卵巢癌术后切除较理想的值。镇静不能满意的患者需个性化追加镇痛药。
Objective: To observe the effects and adverse reactions of different concentrations of sufentanil for intravenous controlled analgesia after ovariectomy. Methods: A total of 96 patients undergoing transabdominal oophorectomy (all epidural anesthesia, ASI Ⅰ ~ Ⅱ) undergoing elective surgery from June 2009 to March 2012 were selected. Postoperative intravenous controlled analgesia. Patients were randomized into 4 groups to perform controlled analgesia with 0.5 μg / ml, 0.75 μg / ml sufentanil, 1.25 μg / ml, and 1.75 μg / ml sufentanil. The basis of analgesic dose of 4 ml / h, controlled dose of 2 ml / h, locking time was 20 min. Observe the analgesic effect of each group, add the number of analgesic use, adverse conditions and other analgesic use. Results: The pain relieving effect of 1.25μg / ml and 1.75μg / ml group was better than that of 0.5μg / ml and 0.75μg / ml group after 16 hours. The analgesic effect of 1.25μg / ml group was obvious at 16 hours and 24 hours VAS in the group of 0.5μg / ml and 0.75μg / ml, 1.75μg / ml at 24h and 48h was significantly lower than that of 1.25μg / ml, all of the four groups had different degrees of side effects, but no significant difference Blood pressure, decreased respiratory and other serious side effects. CONCLUSIONS: Sufentanil intravenous controlled analgesia after ovariectomy is 1.25μg / ml and the flow rate is 2 ml / h. The duration of 20 min may be an ideal value for resection of ovarian cancer. Sedation patients can not be satisfied with the need to add additional analgesics.