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丙泊酚联合瑞芬太尼对腹式子宫切除术后患者疼痛及心率管理的影响

The Effect of Propofol plus Remifentanil for PostoperativePain and Heart Rate Management in Patients Undergoing Abdominal Hysterectomy.

作者信息

Zhang Li, Wang Yuping, Zhang Longxin, Chen Xiaofen, Zhou Min

机构信息

Department of Anesthesiology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, 18 Daoshan Road, Fuzhou 350001, Fujian, China.

出版信息

Evid Based Complement Alternat Med. 2022 Jul 9;2022:7646361. doi: 10.1155/2022/7646361. eCollection 2022.

Abstract

PURPOSE

To explore the effect of propofol plus remifentanil for postoperative pain and heart rate management in patients undergoing abdominal hysterectomy.

METHODS

In this prospective randomized controlled study, 96 patients who underwent abdominal hysterectomy in an affiliated hospital of Fujian Medical University from April 2016 to April 2017 were recruited and randomized into the study group ( = 48) and control group ( = 48) via the random number table method. The control group received remifentanil for anesthesia, and the study group was given propofol plus remifentanil. The postoperative pain and heart rates of patients were compared between the two groups.

RESULTS

No significant difference was observed in the heart rate and adrenaline values between the two groups before anesthesia, and the study group had significantly lower adrenaline values and heart rates intraoperatively and 15 min after operation than the control group. Patients in the study group showed shorter time-lapse before independent breathing recovery, extubation, and resuscitation compared to those in the control group. The study group received less patient-controlled intravenous analgesia (PCIA) as compared to the study group within 48 h after operation. In the study group, the numeric rating scale (NRS) scores within 1 h, 2 h, 6 h, 8 h, and 12 h after operation were significantly lower than those in the control group ( < 0.001). Propofol plus remifentanil offer a viable alternative for postoperative pain management and stress alleviation after abdominal hysterectomy with a high safety profile. Further clinical trials are, however, required prior to clinical promotion.

摘要

目的

探讨丙泊酚联合瑞芬太尼用于腹式子宫切除术后疼痛及心率管理的效果。

方法

在这项前瞻性随机对照研究中,选取2016年4月至2017年4月在福建医科大学附属某医院接受腹式子宫切除术的96例患者,通过随机数字表法将其随机分为研究组(n = 48)和对照组(n = 48)。对照组采用瑞芬太尼进行麻醉,研究组给予丙泊酚联合瑞芬太尼。比较两组患者术后疼痛及心率情况。

结果

两组患者麻醉前心率及肾上腺素值比较,差异无统计学意义;研究组术中及术后15分钟时的肾上腺素值及心率均显著低于对照组。与对照组相比,研究组患者自主呼吸恢复、拔管及苏醒时间更短。术后48小时内,研究组患者自控静脉镇痛(PCIA)使用量少于对照组。研究组术后1小时、2小时、6小时、8小时及12小时的数字评分量表(NRS)评分均显著低于对照组(P < 0.001)。丙泊酚联合瑞芬太尼为腹式子宫切除术后疼痛管理及减轻应激提供了一种安全有效的替代方案。然而,在临床推广之前还需要进一步的临床试验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3290/9288277/c349a7923518/ECAM2022-7646361.001.jpg

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