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七氟醚、异氟醚及丙泊酚麻醉对术后疼痛的影响
Postoperative pain after anesthesia with sevoflurane, isoflurane or propofol
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DOI:
作者:
刘华
Liu Hua
作者单位:
上海市第一人民医院疼痛科
Department of Analgesiology, Shanghai Jiaotong University affiliated First People’s Hospital
关键词:
七氟醚;异氟醚;丙泊酚;术后疼痛
摘要:
目的 比较吸入七氟醚、异氟醚及静脉泵入丙泊酚维持全身麻醉对术后疼痛的影响。方法 90例行经腹子宫手术操作的患者,随机均分为七氟醚(Sevo组)、异氟醚(Iso组)及丙泊酚(Prop组)组,每组30例。三组患者在静脉诱导插管后,行间歇指令正压通气模式(IPPV)机械通气。术中分别吸入七氟醚、异氟醚或泵注丙泊酚维持全身麻醉。记录三组患者术后1h、2h、4h、8h和24h芬太尼的累积消耗量及静息与咳嗽情况下的疼痛数字分级评分(NRS)。结果 三组患者术后1h、2h、4h、8h和24h,芬太尼累积消耗量无差异(P>0.05)。术后1小时Prop组的静息及咳嗽疼痛评分均显著低于Sevo组和Iso组(P<0.05);术后2小时Prop组的静息及咳嗽疼痛评分均显著低于Iso组(P<0.05),与Sevo组无差异;余各时点三组的静息及咳嗽疼痛评分均无差异。结论 七氟醚、异氟醚与丙泊酚麻醉对术后疼痛的影响不同,七氟醚、异氟醚麻醉的术后疼痛比丙泊酚麻醉更显著,且异氟醚麻醉后的疼痛的持续时间更长,程度更强。
Objective To compare pain intensity during the first 24h postoperatively in patient undergoing abdominal hysterectomy or myomectomy with sevoflurane, isoflurane or propofol. Methods 90 patients undergoing elective abdominal hysterectomy or myomectomy were randomly assigned to 3 groups. There were 30 patients in each group. General anesthesia in group Sevo, group Iso or group Prop were maintained with sevoflurane,isoflurane inhalation or propofol IV TCI respectively after induction. NRSrest, NRScough and cumulative fentanyl consumption were recorded at 1h、2h、4h、8h and 24h after surgeries. Results Cumulative fentanyl consumption did not differ among the 3 groups at 1h、2h、4h、8h or 24h postoperatively(P>0.05). NRSrest, NRScough 1h postoperatively in group Prop were significantly lower than those in group Sevo and Iso(P<0.05); NRSrest, NRScough 2h postoperatively in group Prop were significantly lower than that in group Iso (P<0.05), but did not differ from that in group Sevo. NRS at other time point did not differ among the 3 groups.Conclusion General anesthesia maintained with sevoflurane,isoflurane inhalation or propofol IV perfusion showed different effects on postoperative pain. Postoperative pain was stronger in general anesthesia maintained with isoflurane and sevoflurane inhalation compared with propofol IV perfusion. Moreover, postoperative pain was stronger and lasted longer in general anesthesia maintained with isoflurane.
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