绝经对女性舒芬太尼术后镇痛效果的影响

目的: 观察女性绝经后雌激素水平变化对舒芬太尼术后镇痛效果的影响。方法: 全麻腹式子宫全切除术患者60 例,ASA I-Ⅱ级,随机分为 2组,绝经期女性组(Ⅰ组)与未绝经期女性组(Ⅱ组),每组30例,两组术后均行病人自控镇痛(PCA)。PCA配置方法:舒芬太尼 100 mg+恩丹西琼 8 mg 以生理盐水配至 100 mL,于手术结束前 30 min 连接静脉镇痛泵,均以 2 mL／h 的速度持续静脉泵输入。记录患者连接止痛泵后4、8、12、24、36、48 h的视觉模拟评分(VAS)、Ramsay镇静评分和不良反应。结果: 两组患者术后VAS评分均小于3,且2组间差异无统计学意义;两组4、8、12、24、36、48 h 的镇静评分<4,相比差异无统计学意义;两组不良反应,呼吸抑制、恶心、呕吐及皮肤瘙痒发生率相比均无统计学差异。结论: 女性绝经前后雌激素水平变化对舒芬太尼术后镇痛效果无显著影响。舒芬太尼用于患者术后镇痛的效果良好,不良反应发生率低,有临床推广价值。

Effects of female menopause on sufentanil postoperative intravenous analgesia after transabdomial hyteromyomectomy

AIM: To observe the change of female estrogens on effects and side effects of sufentanil for postoperative intravenous analgesia after transabdominal hysteromyomectomy(TAH).METHODS: Sixty patients for TAH,ASA I-II ,were divided into two groups:I (premenopansal group)and Ⅱ(postmenopausal group), with 30 cases each. Sufentanil 100 mg and ondanstrone 8 mg were diluted with saline into 100 mL and continuously infused at the rate of 2 mL/h before 30 min end of operation.Visual analogue scale(VAS),Ramsay sedation scale and side effects were recorded at 4,8, 12,24,36,and 48 h postoperatively.RESULTS: Two groups had no significant difference in analgesic effects and sedation scale,VAS of all groups were below 3, sedation scale of two groups were lower than 4.The incidence of side effects -respiratory depression,nausea,vomiting and pruritus were no significant difference in the two groups.CONCLUSION: The change of female estrogens has no significant effects on sufentanil postoperative intravenous analgesia after TAH. Intravenous sufentanil can produce reliable postoperative analgesia for patients with TAH and with fewer adverse effects.