Effects of different analgesics on postoperative agitation in adult patients after general anesthesia
Effects of different analgesics on postoperative agitation in adult patients after general anesthesia
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不同镇痛药对成人全麻患者术后躁动的影响
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发表时间：
2011
期刊：
影响因子：
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通讯作者：
C. Fei
中科院分区：
文献类型：
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作者：
C. Fei
目的比较芬太尼、曲马多、布托啡诺、帕瑞昔布对全麻术后躁动的影响。方法选择阿萨Ⅰ或Ⅱ级全麻术后躁动的成年患者120例，随机分为芬太尼1 μg/kg组（F组）、曲马多1 mg/kg组（T组）、布托啡诺1 mg/kg组（C组），分别静脉注射芬太尼1 mg/kg、曲马多1 mg/kg、布托啡诺1 mg/kg、帕瑞昔布1 mg/kg、帕瑞昔布1 mg/kg、芬太尼1 mg/kg、曲马多1 mg/kg、布托啡诺1 mg/kg、帕瑞昔布1 mg/kg。分别给予布托啡诺20 μg/kg（B组）和帕瑞昔B 40 mg（P组），观察两组患者VAS评分、M-H评分、治疗前后采用Ramsay镇静评分法和RSS躁动评分法进行评定，观察术后躁动的可能原因及患者在麻醉后恢复室（PACU）的停留时间结果术后疼痛、尿管刺激是引起躁动的主要原因，芬太尼、布托啡诺、帕瑞昔布能有效缓解躁动，经治疗后，所有组的VAS和Ramsay值均降低，Ramsay值升高但T组VAS评分仍高于其他3组（P0.05 B组Ramsay评分高于其他3组，PACU停留时间长于其他3组（P0.05结论帕瑞昔布治疗术后躁动安全有效，芬太尼可引起暂时性呼吸抑制，布托啡诺可延长PACU停留时间，曲马多不宜用于术后躁动的治疗。
Objective To compare the effects of fentanyl,tramadol,butorphanol and parecoxib on postoperative agitation in adult patients after general anesthesia.MethodsOne hundred and twenty ASA Ⅰ or Ⅱ adult patients suffered from postoperative agitation after general anesthesia were randomized into four groups.They received intravenously fentanyl 1 μg/kg(group F),tramadol 1 mg/kg(group T),butorphanol 20 μg/kg(group B)and parecoxib 40 mg(group P)respectively.The VAS scale,Prince-Henry scale,Ramsay sedation scale and RSS agitation scale were assessed before and after treatment.The possible causes of postoperative agitation and duration of patient stay in postanesthesia care unit(PACU)were recorded.ResultsPostoperative pain and urinal catheter stimulation were the main causes of agitation.Fentanyl,butorphanol and parecoxib could relieve agitation effectively.After treatment,VAS and Prince-Henry values decreased and Ramsay values increased in all groups(P0.05).But VAS value in group T was still higher than that in the other three groups(P0.05).Ramsay values were higher and PACU stay was longer in group B than those in the other three groups(P0.05).ConclusionParecoxib is a safe and effective drug for postoperative agitation.Fentanyl may be associated with temporary respiratory depression.Butorphanol can prolong PACU stay.Tramadol is not suitable for the treatment of agitation.