中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2012年
3期
27-30
,共4页
注射,脊髓%舒芬太尼%超前镇痛%骨科手术
註射,脊髓%舒芬太尼%超前鎮痛%骨科手術
주사,척수%서분태니%초전진통%골과수술
Injections,spinal%Sufentanil%Preemptive analgesia%Orthopaedic surgery
目的 对鞘内注射舒芬太尼超前镇痛用于下肢骨科手术的安全剂量进行筛选.方法 选择ASA分级Ⅰ～Ⅱ级、于蛛网膜下隙与硬膜外隙联合阻滞下行择期下肢骨科手术患者96例,按随机数字表法双盲分为六组,每组16例.Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ、Ⅵ组鞘内分别给予舒芬太尼0.05、0.10、0.15、0.20、0.25、0μg/kg及0.5％左布比卡因重密度混合液2.5 ml.观察记录痛觉阻滞平面达到T10所持续的时间,术后2、4、6、8、12、24、48 h的视觉模拟评分(VAS),术后不良反应.结果 Ⅰ～Ⅵ组痛觉阻滞平面达到T10所持续的时间分别为(245.6±34.2)、(259.3±36.7)、(268.9±37.8)、(286.6±38.8)、(287.7±39.1)、(228.6±31.4) min,Ⅳ组与Ⅴ组比较差异无统计学意义(P＞0.05),其他各组间比较差异均有统计学意义(P＜0.05).术后6、8、12、24、48 h,Ⅲ组、Ⅳ组与Ⅴ组VAS比较差异无统计学意义(P＞0.05),均低于其他三组(P＜0.05).术后Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅵ组均未发生呼吸抑制,Ⅴ组发生4例.结论 鞘内注射舒芬太尼超前镇痛用于下肢骨科手术的最佳安全剂量为0.20μg/kg.
目的 對鞘內註射舒芬太尼超前鎮痛用于下肢骨科手術的安全劑量進行篩選.方法 選擇ASA分級Ⅰ～Ⅱ級、于蛛網膜下隙與硬膜外隙聯閤阻滯下行擇期下肢骨科手術患者96例,按隨機數字錶法雙盲分為六組,每組16例.Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ、Ⅵ組鞘內分彆給予舒芬太尼0.05、0.10、0.15、0.20、0.25、0μg/kg及0.5％左佈比卡因重密度混閤液2.5 ml.觀察記錄痛覺阻滯平麵達到T10所持續的時間,術後2、4、6、8、12、24、48 h的視覺模擬評分(VAS),術後不良反應.結果 Ⅰ～Ⅵ組痛覺阻滯平麵達到T10所持續的時間分彆為(245.6±34.2)、(259.3±36.7)、(268.9±37.8)、(286.6±38.8)、(287.7±39.1)、(228.6±31.4) min,Ⅳ組與Ⅴ組比較差異無統計學意義(P＞0.05),其他各組間比較差異均有統計學意義(P＜0.05).術後6、8、12、24、48 h,Ⅲ組、Ⅳ組與Ⅴ組VAS比較差異無統計學意義(P＞0.05),均低于其他三組(P＜0.05).術後Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅵ組均未髮生呼吸抑製,Ⅴ組髮生4例.結論 鞘內註射舒芬太尼超前鎮痛用于下肢骨科手術的最佳安全劑量為0.20μg/kg.
목적 대초내주사서분태니초전진통용우하지골과수술적안전제량진행사선.방법 선택ASA분급Ⅰ～Ⅱ급、우주망막하극여경막외극연합조체하행택기하지골과수술환자96례,안수궤수자표법쌍맹분위륙조,매조16례.Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ、Ⅵ조초내분별급여서분태니0.05、0.10、0.15、0.20、0.25、0μg/kg급0.5％좌포비잡인중밀도혼합액2.5 ml.관찰기록통각조체평면체도T10소지속적시간,술후2、4、6、8、12、24、48 h적시각모의평분(VAS),술후불량반응.결과 Ⅰ～Ⅵ조통각조체평면체도T10소지속적시간분별위(245.6±34.2)、(259.3±36.7)、(268.9±37.8)、(286.6±38.8)、(287.7±39.1)、(228.6±31.4) min,Ⅳ조여Ⅴ조비교차이무통계학의의(P＞0.05),기타각조간비교차이균유통계학의의(P＜0.05).술후6、8、12、24、48 h,Ⅲ조、Ⅳ조여Ⅴ조VAS비교차이무통계학의의(P＞0.05),균저우기타삼조(P＜0.05).술후Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅵ조균미발생호흡억제,Ⅴ조발생4례.결론 초내주사서분태니초전진통용우하지골과수술적최가안전제량위0.20μg/kg.
Objective To selected the safe dosage of intrathecal injection of sufentanil for preemptive analgesia in lower limb orthopaedic surgery.Methods Selected 96 patients who ASA classification Ⅰ - Ⅱ grades undergoing elective lower limb orthopaedic surgery with subarachnoid epidural block down,they were divided into six groups by random number table and double blind method,each group of 16 cases.Group Ⅰ,Ⅱ,Ⅲ,Ⅳ,Ⅴ,Ⅵ received 0.05,0.10,0.15,0.20,0.25,0 μ g/kg of intrathecal sufentanil and 2.5 ml of 0.5％ levobupivacaine.Observed and recorded the duration of block level of pain to T10,visual analog score (VAS)postoperative at 2,4,6,8,12,24,48 h,and side effects.Results The duration of block level of pain to T10 of group Ⅰ,Ⅱ,Ⅲ,Ⅳ,Ⅴ,Ⅵ was (245.6 ± 34.2),(259.3 ± 36.7),(268.9 ± 37.8),(286.6 ± 38.8),(287.7 ± 39.1 ),(228.6 ± 31.4) min.There was no significant difference between group Ⅳ and group Ⅴ (P ＞ 0.05 ),the differences of other groups were statistically significant (P ＜ 0.05 ).Compared with group Ⅴ,VAS of group Ⅲ and group Ⅳ at 6,8,12,24,48 h after operation was not statistically significant (P ＞ 0.05),and they were lower than the other three groups (P ＜ 0.05 ).There were no respiratory depression occurred after operation in group Ⅰ,Ⅱ,Ⅲ,Ⅳ,Ⅵ,4 cases occurred in group Ⅴ.Conclusion The best of effective dose of intrathecal injection of sufentanil for preemptive analgesia in lower limb orthopaedic surgery is 0.20 μ g/kg.
