中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2010年
36期
8-11
,共4页
王尔华%徐洁%戴黎敏%马正良
王爾華%徐潔%戴黎敏%馬正良
왕이화%서길%대려민%마정량
子宫切除术%利多卡因%曲马多%瑞芬太尼
子宮切除術%利多卡因%麯馬多%瑞芬太尼
자궁절제술%리다잡인%곡마다%서분태니
Hysterectomy%Lidocaine%Tramadol%Remifentanil
目的 评估利多卡因和曲马多对瑞芬太尼复合全身麻醉效果的影响.方法 将80例在瑞芬太尼复合全身麻醉下行经腹子宫切除术患者按随机数字表法分为四组,每组20例.LT组:诱导时静脉输注利多卡因1 mg/kg,继以2 mg/(kg·h)持续泵注至手术结束,诱导时、手术结束前30min各静脉注射曲马多1.5 mg/kg;L组:单用利多卡因,方法同LT组;T组:单用曲马多,方法同LT组;对照组:以0.9%氯化钠替代.记录围手术期平均动脉压(MAP)、心率、躁动评分(RS)、Ramsay镇静评分(RSS)、视觉模拟评分(VAS)、拔管时间、药物使用情况、并发症等.结果 与其他三组比较,LT组手术期间普鲁泊福用量[(450±178)mg]少,拔管时间[(15.0±4.8)win]短,苏醒期间躁动发生率低、RSS高,在麻醉后加强监护病房(PACU)仅1例使用芬太尼,术后48 h内仅1例肌肉注射哌替啶;L组苏醒期间有RS高于、RSS低于、在PACU芬太尼使用例数多于、而术后48 h内肌肉注射哌替啶例数少于T组趋势.结论 围手术期使用利多卡因可较好地减轻术后疼痛,减少术后镇痛药用量,使用曲马多可降低瑞芬太尼复合全身麻醉苏醒期间的急性疼痛及躁动发生率,两者联用能取得更好的效果.
目的 評估利多卡因和麯馬多對瑞芬太尼複閤全身痳醉效果的影響.方法 將80例在瑞芬太尼複閤全身痳醉下行經腹子宮切除術患者按隨機數字錶法分為四組,每組20例.LT組:誘導時靜脈輸註利多卡因1 mg/kg,繼以2 mg/(kg·h)持續泵註至手術結束,誘導時、手術結束前30min各靜脈註射麯馬多1.5 mg/kg;L組:單用利多卡因,方法同LT組;T組:單用麯馬多,方法同LT組;對照組:以0.9%氯化鈉替代.記錄圍手術期平均動脈壓(MAP)、心率、躁動評分(RS)、Ramsay鎮靜評分(RSS)、視覺模擬評分(VAS)、拔管時間、藥物使用情況、併髮癥等.結果 與其他三組比較,LT組手術期間普魯泊福用量[(450±178)mg]少,拔管時間[(15.0±4.8)win]短,囌醒期間躁動髮生率低、RSS高,在痳醉後加彊鑑護病房(PACU)僅1例使用芬太尼,術後48 h內僅1例肌肉註射哌替啶;L組囌醒期間有RS高于、RSS低于、在PACU芬太尼使用例數多于、而術後48 h內肌肉註射哌替啶例數少于T組趨勢.結論 圍手術期使用利多卡因可較好地減輕術後疼痛,減少術後鎮痛藥用量,使用麯馬多可降低瑞芬太尼複閤全身痳醉囌醒期間的急性疼痛及躁動髮生率,兩者聯用能取得更好的效果.
목적 평고리다잡인화곡마다대서분태니복합전신마취효과적영향.방법 장80례재서분태니복합전신마취하행경복자궁절제술환자안수궤수자표법분위사조,매조20례.LT조:유도시정맥수주리다잡인1 mg/kg,계이2 mg/(kg·h)지속빙주지수술결속,유도시、수술결속전30min각정맥주사곡마다1.5 mg/kg;L조:단용리다잡인,방법동LT조;T조:단용곡마다,방법동LT조;대조조:이0.9%록화납체대.기록위수술기평균동맥압(MAP)、심솔、조동평분(RS)、Ramsay진정평분(RSS)、시각모의평분(VAS)、발관시간、약물사용정황、병발증등.결과 여기타삼조비교,LT조수술기간보로박복용량[(450±178)mg]소,발관시간[(15.0±4.8)win]단,소성기간조동발생솔저、RSS고,재마취후가강감호병방(PACU)부1례사용분태니,술후48 h내부1례기육주사고체정;L조소성기간유RS고우、RSS저우、재PACU분태니사용례수다우、이술후48 h내기육주사고체정례수소우T조추세.결론 위수술기사용리다잡인가교호지감경술후동통,감소술후진통약용량,사용곡마다가강저서분태니복합전신마취소성기간적급성동통급조동발생솔,량자련용능취득경호적효과.
Objective To evaluate the effect of lidocaine and tramadol on remifentanil combined general anesthesia. Methods Eighty patients undergoing abdominal hysterectomy were divided into group LT,L,T and C by random digits table,each with 20 cases .In group LT,during induction,the patients were intravenously. In group L,only used lidocaine as introduced in group LT. In group T,only used tramadol as shown in group LT. In group C,used the same volume of saline solution. The changes of mean arterial pressure (M A P) and heart rate during the operation, dysphoria grade (RS), Ramsay score (RSS), pain score (VAS),extubation time(ET),medication and dose,complications were recorded. Results In group LT,the dosage of propofol [(450 ± 178) mg] was less (P ＜ 0.05), ET [(15.0 ± 4.8) min] was shorter (P ＜ 0.05),during recovery time, RS was lower, RSS was higher,the cases needad fentanyl (1 case), 48 h after operation, only 1 case needed pethidine to relieve pain was less than those in other groups (P ＜ 0.05). In group L there was a tend that its RS and the cases needed fentanyl and fentanyl dosage were more, RSS was less than those in group T during recovery time,but 48 h after operation,the cases needed pethidine was less than that in group T. Conclusions Using lidocaine during operation may relieve pain after operation, reduce the dosage of analgesic;giving tramadol may alleviate the acute pain and lower dysphoria incidence rate after remifentanil anesthesia. Combining them will get a better effect.
