中国临床实用医学
中國臨床實用醫學
중국림상실용의학
CHINA CLINICAL PRACTICAL MEDICINE
2008年
2期
9-11
,共3页
恩再适%芬太尼%镇痛,静脉%子宫全切术
恩再適%芬太尼%鎮痛,靜脈%子宮全切術
은재괄%분태니%진통,정맥%자궁전절술
Analgecine%Fentanyl%Analgesia%Intravenous%Hysterectomy
目的 比较术前预用恩再适对不同剂量芬太尼用于子宫全切术后患者自控静脉镇痛的影响.方法 选择全麻下子宫全切术的患者120例,术后采用芬太尼经生理盐水稀释后行患者自控静脉镇痛(PCIA),并根据不同的用药方法随机分为四组:A组,芬太尼1 mg+0.9%NaCl共100 ml;B组,芬太尼0.5 mg+0.9%NaCl共100 ml;C组,术前晚、麻醉前、术毕各经静脉注射恩再适3.6 U,芬太尼0.7 mg+0.9%NaCl共100 ml;D组,术前晚、麻醉前、术毕各经静脉注射恩再适7.2 U,芬太尼0.5 mg+0.9%NaCl共100 ml,每组30例.术后24 h内采用视觉模拟评分(VAS)、PCA按压次数来观察各组镇痛效应及恶心呕吐、嗜睡等不良反应的发生率.结果 B组术后2 h时的VAS评分显著高于A、C和D组(P<0.05),而2 h后的VAS四组间差异无统计学意义(P>0.05).24 h内的PCA按压次数B组显著多于A、C和D组(P<0.05).B、C和D组中恶心、呕吐、皮肤瘙痒及嗜睡等不良反应的发生率显著低于A组(P<0.05).镇痛期间无呼吸抑制、异常出血等严重并发症的发生.结论 术前预用恩再适复合小剂量芬太尼用于子宫全切术后静脉镇痛可取得满意的镇痛效果,并能减少芬太尼的用量及不良反应的发生率.
目的 比較術前預用恩再適對不同劑量芬太尼用于子宮全切術後患者自控靜脈鎮痛的影響.方法 選擇全痳下子宮全切術的患者120例,術後採用芬太尼經生理鹽水稀釋後行患者自控靜脈鎮痛(PCIA),併根據不同的用藥方法隨機分為四組:A組,芬太尼1 mg+0.9%NaCl共100 ml;B組,芬太尼0.5 mg+0.9%NaCl共100 ml;C組,術前晚、痳醉前、術畢各經靜脈註射恩再適3.6 U,芬太尼0.7 mg+0.9%NaCl共100 ml;D組,術前晚、痳醉前、術畢各經靜脈註射恩再適7.2 U,芬太尼0.5 mg+0.9%NaCl共100 ml,每組30例.術後24 h內採用視覺模擬評分(VAS)、PCA按壓次數來觀察各組鎮痛效應及噁心嘔吐、嗜睡等不良反應的髮生率.結果 B組術後2 h時的VAS評分顯著高于A、C和D組(P<0.05),而2 h後的VAS四組間差異無統計學意義(P>0.05).24 h內的PCA按壓次數B組顯著多于A、C和D組(P<0.05).B、C和D組中噁心、嘔吐、皮膚瘙癢及嗜睡等不良反應的髮生率顯著低于A組(P<0.05).鎮痛期間無呼吸抑製、異常齣血等嚴重併髮癥的髮生.結論 術前預用恩再適複閤小劑量芬太尼用于子宮全切術後靜脈鎮痛可取得滿意的鎮痛效果,併能減少芬太尼的用量及不良反應的髮生率.
목적 비교술전예용은재괄대불동제량분태니용우자궁전절술후환자자공정맥진통적영향.방법 선택전마하자궁전절술적환자120례,술후채용분태니경생리염수희석후행환자자공정맥진통(PCIA),병근거불동적용약방법수궤분위사조:A조,분태니1 mg+0.9%NaCl공100 ml;B조,분태니0.5 mg+0.9%NaCl공100 ml;C조,술전만、마취전、술필각경정맥주사은재괄3.6 U,분태니0.7 mg+0.9%NaCl공100 ml;D조,술전만、마취전、술필각경정맥주사은재괄7.2 U,분태니0.5 mg+0.9%NaCl공100 ml,매조30례.술후24 h내채용시각모의평분(VAS)、PCA안압차수래관찰각조진통효응급악심구토、기수등불량반응적발생솔.결과 B조술후2 h시적VAS평분현저고우A、C화D조(P<0.05),이2 h후적VAS사조간차이무통계학의의(P>0.05).24 h내적PCA안압차수B조현저다우A、C화D조(P<0.05).B、C화D조중악심、구토、피부소양급기수등불량반응적발생솔현저저우A조(P<0.05).진통기간무호흡억제、이상출혈등엄중병발증적발생.결론 술전예용은재괄복합소제량분태니용우자궁전절술후정맥진통가취득만의적진통효과,병능감소분태니적용량급불량반응적발생솔.
Objective To compare the effect of preoperative intravenous injection of Analgecine on the analgesic efficacy and complications of patient-controlled intravenous analgesia(PCA) of different doses of fenta- nyl in postoperative total hysterectomy patients. Methods 120 patients undergoing total hysterectomy in general anesthesia were randomly divided into four groups with thirty cases each. Fentanyl 1 mg in group A ,fentanyl 0.5 mg in group B,fentanyl 0. 7 mg in group C,fentanyl 0. 5 mg in group D. The drugs in each group were diluted to 100 ml and infused by pumps. Besides,the patients in group C and D were injected with Anaigecine 3.6 U and 7. 2 U at the night before the operation, preoperation and postoperation respectively. The visual analog scale (VAS) ,times of PCA and incidence of side effects were recorded during the period of postoperative 24 hours. Results The VAS of group B at 2 h after operation was significantly higher than that of group A, C and D (P < 0.05) ,which became similar 2 h later(P > 0. 05). The demanding times for supplemental bolus in group B was also significantly higher than that of A, C and D (P < 0. 05). The incidence of nausea, vomiting, itching, somno- lence in group B, C and D were significantly less than those in group A (P < 0.05). No respiratory depression or abnormal bleeding occurred in four groups. Conclusion Preoperative intravenous injection of Analgecine has a better effect on patient-controlled intravenous analgesia(PCIA) of fentanyl and can reduce fentanyl requirement and its side effects in total hysterectomy patients.
