不同镇痛药用于超前镇痛的临床分析

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1、不同镇痛药用于超前镇痛的临床分析苏利伟任应娜李真宝鸡市中心医院麻醉科陕丙宝鸡721000【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ASA1—II级胃癌手术患者.C组帕瑞昔布钠4Omg、P组氟比洛芬酯10Omg、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<

2、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

3、洛芬酸;布托啡诺【Abstract】Objective:TostudytheeffectsoftheintravenousinjectionofParecoxibSodium、FlurbiprofenaxetilandButorphanolTartrateonthepostoperaGtivesedationandanalgesiaofpatients.Approach:120casesofgeneralanesthesiawerechosen,whowerepatientsofASAI—IIgastriccanceropera

4、tion.GroupCParecoxibSodium40mg,groupPFIurbiprofenaxetil100mg,groupNButorphanolTartrate2mg,andthecontrolgroupSFentanyl0.05mgweresetuptoanalyzetheireffectsontherecoveryperiodandrelatedadversereaction.Result:ThepostoperativeVSAscoresofgroupC,groupPandgroupNateachtimepoi

5、ntwereobviouslylowerthanthoseofgroupS(P<0.05);TheVSAofgroupNwithinthefirsthourafteroperationwaslowerthangroupPandgroup^whileitwashigherthangroupPandgroupC(P<0.05)twohoursaftertheoperation;TheVSAofgroupCwaslowerthangroupP(P<0.05)6hoursaftertheoperation;TheRamsaysedati

6、onscoreofgroupNwashigherthangroupC,groupPandgroupS(P<0.05)inthefirsttwohoursaftertheoperation,andtheRamsaydifferenceshowednosignificanceinothertimepoints(P>0.05);Conclusion:ParecoxibSodium、FlurbiprofenaxetilandButorphanolTartrateareallbeneficialtothetransiGtionofpati

7、entsinrecoveryperiod.Theydon’taffectbreathingrecoverytime,extubationtimeandwakingtime,causinglesspostoperativeadversereaction,helpGingtoachieveagoodanalgesiceffect.However,theyhavetheirrespectiveadvantages.ButorphanolTartratehasagoodearlyanalgesiceffect,butther

8、earehighratesofdrowsiness;ThedurationofanalgesiaofFlurbiprofenaxetilandParecoxibSodiumislong,especiallyParecoxibSodium-Asaresult,th