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目的:探讨丙帕他莫复合芬太尼作为腹腔镜子宫肌瘤剔除术术后镇痛药的临床效果及安全性。方法:择期行腹腔镜子宫肌瘤剔除术的患者72例,ASA分级Ⅰ～Ⅱ级,随机分为A、B两组,每组各36例。A、B两组均于术毕前15 min给予芬太尼1μg.kg-1。术后镇痛泵配方:A组给予丙帕他莫2 mg+芬太尼8μg.kg-1+托烷司琼10 mg+0.9%生理盐水至100 ml,B组给予芬太尼16μg.kg-1+托烷司琼10 mg+0.9%生理盐水至100 ml,以2 ml.h-1速率连接静脉镇痛泵,单次剂量0.5 ml,锁定时间15 min;比较镇痛效果及不良反应。结果:两组在术后4、8、12、16、24、48 h镇痛、镇静效果及各项生命体征方面差异无统计学意义(P>0.05),但术后A组不良反应发生率和药物用量比B组少(P<0.05)。结论:丙帕他莫复合芬太尼用于腹腔镜子宫肌瘤剔除术术后镇痛效果明确、不良反应低,值得临床推广。
Objective: To investigate the clinical efficacy and safety of propatinam combined with fentanyl as postoperative analgesic for laparoscopic myomectomy. Methods: Seventy-two patients undergoing laparoscopic myomectomy were randomly divided into A and B groups, with 36 cases in each group. A and B were given fentanyl 1μg.kg-1 15 min before operation. Postoperative analgesia pump formula: Group A was given propatinam 2mg + fentanyl 8μg.kg-1 + tropisetron 10mg + 0.9% saline to 100ml, group B was given fentanyl 16μg.kg- 1 + tropisetron 10 mg + 0.9% saline to 100 ml at a rate of 2 ml.h-1 intravenous analgesia pump, a single dose of 0.5 ml, locking time 15 min; analgesic effect and adverse reactions. Results: There was no significant difference in analgesic, sedation and vital signs between the two groups at 4, 8, 12, 16, 24 and 48 h after operation (P> 0.05), but the incidence of adverse reactions in group A And the amount of medication less than the B group (P <0.05). CONCLUSION: Propatinam combined with fentanyl has a clear analgesic effect after laparoscopic myomectomy and low adverse reactions, which is worthy of clinical promotion.