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  • 简介:摘要目的研究帕瑞昔布钠、氟比洛芬酯、布托啡诺静脉注射对患者术后镇痛镇静的影响.方法选取全身麻醉120例ASAⅠ-Ⅱ级胃癌手术患者.C组帕瑞昔布钠40mg、P组氟比洛芬酯100mg、N组布托啡诺2mg、S组芬太尼0.05mg,分析其对苏醒期的影响.结果术后各时点VSA评分C组、P组、N组均明显低于S组(P<0.05);N组在术后1小时内VSA低于P、C组,在2小时后VSA高于P、C组(P<0.05);C组在术后VSA6小时后低于P组(P<0.05);N组在术后2小时前Ramsay镇静评分高于C组、P组、S组(P<0.05),余时间点比较Ramsay差异无统计学意义(P>0.05);C组、P组、S组比较Ramsay差异无统计学意义(P>0.05);结论布托啡诺、帕瑞昔布钠、氟比洛芬酯均有利于患者苏醒期的过渡,不影响拔管时间、清醒时间,术后不良反应少,均能取得良好的镇痛效果.但三者各有优势,布托啡诺早期镇痛效果好,但嗜睡发生率高;氟比洛芬酯、帕瑞昔布钠镇痛持续时间更长,帕瑞昔布钠尤为突出.临床使用时应结合病情个体化用药.关键词全身麻醉;术后镇痛;帕瑞昔布钠;氟比洛芬酯;布托啡诺AbstractObjectiveTostudytheeffectsoftheintravenousinjectionofParecoxibSodium、FlurbiprofenaxetilandButorphanolTartrateonthepostoperaGtivesedationandanalgesiaofpatients.Approach120casesofgeneralanesthesiawerechosen,whowerepatientsofASAⅠ-Ⅱgastriccanceroperation.GroupCParecoxibSodium40mg,groupPFlurbiprofenaxetil100mg,groupNButorphanolTartrate2mg,andthecontrolgroupSFentanyl0.05mgweresetuptoanalyzetheireffectsontherecoveryperiodandrelatedadversereaction.ResultThepostoperativeVSAscoresofgroupC,groupPandgroupNateachtimepointwereobviouslylowerthanthoseofgroupS(P<0.05);TheVSAofgroupNwithinthefirsthourafteroperationwaslowerthangroupPandgroupC,whileitwashigherthangroupPandgroupC(P<0.05)twohoursaftertheoperation;TheVSAofgroupCwaslowerthangroupP(P<0.05)6hoursaftertheoperation;TheRamsaysedationscoreofgroupNwashigherthangroupC,groupPandgroupS(P<0.05)inthefirsttwohoursaftertheoperation,andtheRamsaydifferenceshowednosignificanceinothertimepoints(P>0.05);ConclusionParecoxibSodium、FlurbiprofenaxetilandButorphanolTartrateareallbeneficialtothetransiGtionofpatientsinrecoveryperiod.Theydon’taffectbreathingrecoverytime,extubationtimeandwakingtime,causinglesspostoperativeadversereaction,helpGingtoachieveagoodanalgesiceffect.However,theyhavetheirrespectiveadvantages.ButorphanolTartratehasagoodearlyanalgesiceffect,buttherearehighratesofdrowsiness;ThedurationofanalgesiaofFlurbiprofenaxetilandParecoxibSodiumislong,especiallyParecoxibSodium.Asaresult,theclinicaluseshouldKbeeycwoomrdbsinedwithindividualizedmedicationcondition.Generalanesthesia;Preemptiveanalgesia;Parecoxibsodium;Flurbiprofenaxetil;Butorphanoltartrate中图分类号R614文献标识码B文章编号1001-5302(2015)09-0791-02

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