国际麻醉学与复苏杂志
國際痳醉學與複囌雜誌
국제마취학여복소잡지
INTERNATIONAL JOURNAL OF ANESTHESIOLOGY AND RESUSCITATION
2013年
1期
28-30,52
,共4页
右美托咪定%布托啡诺%术后镇痛%消耗量
右美託咪定%佈託啡諾%術後鎮痛%消耗量
우미탁미정%포탁배낙%술후진통%소모량
Dexmedetomidine%Butorphanol%Postoperative analgesia%Consumption
目的 探讨右美托咪定(dexmedetomidine,Dex)对术后布托啡诺自控镇痛患者疼痛的影响.方法 择期全麻下经腹子宫全切术患者80例,美国麻醉医师协会(ASA)分级Ⅰ或Ⅱ级,按照随机数字表法分为两组,分别在手术结束前1h缓慢泵入(10 min)实验组(Dex组)Dex 0.6μg/kg和对照组(C组)相同体积生理盐水,静脉连接布托啡诺自控镇痛泵,镇痛泵布托啡诺6 mg+托烷司琼5 mg溶于生理盐水100ml,负荷剂量布托啡诺0.5 mg,背景输注1ml/h,自控剂量1ml/h,锁定时间10 min,患者拔出喉罩后进入麻醉后恢复室完全清醒后返回病房.记录经静脉患者自控镇痛(patient controlled intravenous analgesia,PCIA)开始后1、2、6、12 h和24h的视觉模拟(VAS)评分、Ramsay镇静评分(RSS)和布托啡诺累计消耗量；记录术后24h内恶心、呕吐和寒战等发生情况.结果 PCIA后各点两组VAS评分和RSS差异无统计学意义.Dex组布托啡诺各时点累计消耗量明显少于C组(P＜0.05).Dex组术后24 h内恶心、呕吐和寒战的发生率8.6％,2.9％,2.9％明显低于C组17.1％,8.6％,11.4％(P＜0.05).结论 手术结束前1h缓慢泵人Dex 0.6 μg/kg可降低术后布托啡诺用量,并降低术后恶心、呕吐和寒战等副作用.
目的 探討右美託咪定(dexmedetomidine,Dex)對術後佈託啡諾自控鎮痛患者疼痛的影響.方法 擇期全痳下經腹子宮全切術患者80例,美國痳醉醫師協會(ASA)分級Ⅰ或Ⅱ級,按照隨機數字錶法分為兩組,分彆在手術結束前1h緩慢泵入(10 min)實驗組(Dex組)Dex 0.6μg/kg和對照組(C組)相同體積生理鹽水,靜脈連接佈託啡諾自控鎮痛泵,鎮痛泵佈託啡諾6 mg+託烷司瓊5 mg溶于生理鹽水100ml,負荷劑量佈託啡諾0.5 mg,揹景輸註1ml/h,自控劑量1ml/h,鎖定時間10 min,患者拔齣喉罩後進入痳醉後恢複室完全清醒後返迴病房.記錄經靜脈患者自控鎮痛(patient controlled intravenous analgesia,PCIA)開始後1、2、6、12 h和24h的視覺模擬(VAS)評分、Ramsay鎮靜評分(RSS)和佈託啡諾纍計消耗量；記錄術後24h內噁心、嘔吐和寒戰等髮生情況.結果 PCIA後各點兩組VAS評分和RSS差異無統計學意義.Dex組佈託啡諾各時點纍計消耗量明顯少于C組(P＜0.05).Dex組術後24 h內噁心、嘔吐和寒戰的髮生率8.6％,2.9％,2.9％明顯低于C組17.1％,8.6％,11.4％(P＜0.05).結論 手術結束前1h緩慢泵人Dex 0.6 μg/kg可降低術後佈託啡諾用量,併降低術後噁心、嘔吐和寒戰等副作用.
목적 탐토우미탁미정(dexmedetomidine,Dex)대술후포탁배낙자공진통환자동통적영향.방법 택기전마하경복자궁전절술환자80례,미국마취의사협회(ASA)분급Ⅰ혹Ⅱ급,안조수궤수자표법분위량조,분별재수술결속전1h완만빙입(10 min)실험조(Dex조)Dex 0.6μg/kg화대조조(C조)상동체적생리염수,정맥련접포탁배낙자공진통빙,진통빙포탁배낙6 mg+탁완사경5 mg용우생리염수100ml,부하제량포탁배낙0.5 mg,배경수주1ml/h,자공제량1ml/h,쇄정시간10 min,환자발출후조후진입마취후회복실완전청성후반회병방.기록경정맥환자자공진통(patient controlled intravenous analgesia,PCIA)개시후1、2、6、12 h화24h적시각모의(VAS)평분、Ramsay진정평분(RSS)화포탁배낙루계소모량；기록술후24h내악심、구토화한전등발생정황.결과 PCIA후각점량조VAS평분화RSS차이무통계학의의.Dex조포탁배낙각시점루계소모량명현소우C조(P＜0.05).Dex조술후24 h내악심、구토화한전적발생솔8.6％,2.9％,2.9％명현저우C조17.1％,8.6％,11.4％(P＜0.05).결론 수술결속전1h완만빙인Dex 0.6 μg/kg가강저술후포탁배낙용량,병강저술후악심、구토화한전등부작용.
Objective To investigate the effect of dexmedetomidine (Dex) on postoperative pain in patients recieveing patient-controlled butorphanol.Methods Eighty general ansthesia patients (ASA Ⅰ-Ⅱ) undergoing abdominal hysterectomy were randomly devided into 2 groups:Dex group (group D,n=40) and control group (group C,n=40).Patients in group D were received Dex 0.6 μg/kg (in 10 min) and group C were recieved saline respectively by pumped infusion 1 h before the end of operation.All p atients received standadized butorphanol PCIA 1 h before the end of operation,butorphanol 6 mg in 100 ml saline with tropisetron 5 mg,the loading dose was 0.5 mg butorphanol,backgroud dose was 1 ml/h,the controlled dose was 1 ml/h.The lock time was 10 min.Patients whose Aldrete score less than 9 can leave from PACU.The scores of VAS and RSS were recorded 1,2,6,12 h and 24 h after the operation and the incidence rate of the nausea,vomiting and shivering were recorded for 24 h.Results There was no statistical significance between the two groups in the scores of VAS and RSS after PCIA.The consulmption of the butorphanol of the group D was less than the group C (P＜0.05).The incidence of postoperative nausea,vomiting and shivering in the group D was less than group C (P＜0.05).Conclusions The patients received Dex 0.6 μg/kg one hour before the end of operation,needed less consumption of butorphanol and leaded to less postoperative nausea,vomiting or shivering.
