盐酸曲马多、地佐辛、舒芬太尼、盐酸氢吗啡酮防治瑞芬太尼复合麻醉术后超敏痛的效果比较

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Abstract ObjectiveTo compare the clinical effect of Tramadol Hydrochloride,Dezocine,Sufentanil,Hydromorphone Hydrochloride in the prevention and treatment of hypersensitivity pain after Remifentanil combined anesthesia.Methods157 patients with ASA gradeⅠ-Ⅱ who underwent gynecological laparoscopic surgery in our hospital from March 2015 to June 2017 were enrolled in this study,according to the different drugs used before surgery,the patients were divided into group A(Tramadol Hydrochloride,34 cases),group B(Dezocine,43 cases),group C(Sufentanil,39 cases)and group D(Hydromorphone Hydrochloride,41 cases).The recovery time and extubation time,extubation heart rate (HR)and mean arterial pressure (MAP)were compared between the four groups,the VAS scores and Ranmsay sedation scores were compared between the four groups at 15 minutes,1 h,2 h,4 h,8 h,16 h and 24 h postoperatively,and the incidence of adverse reactions during and after extubation in 24 hours were compared.ResultsThe recovery time and extubation time of group D were significantly shorter than those of group A,group B and group C (P＜0.05),and those of group B and group C were significantly shorter than those of group A(P＜0.05),there was no significant difference between the group B and group C in the recovery time and extubation time (P＞0.05).The HR and MAP of extubation of group D were significantly lower than those of group A,group B and group C (P＜0.05),the HR and MAP of extubation of group B and group C were also significantly lower than those of group A (P＜0.05),and there was no significant difference between the group B and group C in the HR and MAP of extubation(P＞0.05).The VAS score at 2 hours to 24 hours after operation in group D were significantly lower than those of group A,group B and group C (P＜0.05),while those of group B and group C were significantly lower than those of group A (P＜0.05),there was no significant difference between group B and group C in the VAS score at 2 hours to 24 hours after operation (P＞0.05).The ramsay sedation scores at 15 minutes to 2 hours after operation in group D were obviously better than those of group A,group B and group C (P＜0.05),those of group B and group C were obviously better than that of group A (P＜0.05),there was no significant difference between group B and group C in the ramsay sedation scores at 15 minutes to 2 hours after operation(P＞0.05).The incidence of adverse reactions in the four groups after extubation and postoperative 24 h was group A＞group B＞group C＞group D,the differences were statistically significant(P＜0.05).ConclusionIn the prevention and treatment of Remifentanil after anesthesia,the effect of Hydromorphone Hydrochloride is the most obvious,it does not affect the recovery and extubation time of the patients,and the incidence of adverse reactions is also the lowest,followed by Dezocine and Sufentanil,both are quite effective,but the adverse effects of Sufentanil postoperative complication rate is lower,and Tramadol Hydrochloride is the worst.

Key words： Remifentanil Hypersensitivity Hydromorphone Hydrochloride Dezocine Sufentanil Tramadol Hydrochloride

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HUA Bing. Effect comparison of Tramadol Hydrochloride,Dezocine,Sufentanil,Hydromorphone Hydrochloride in the prevention and treatment of hypersensitivity pain after Remifentanil combined anesthesia[J]. 中国当代医药, 2018, 25(2): 115-118转122.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2018/V25/I2/115

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