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
33期
18-20
,共3页
右美托咪啶%舒芬太尼%镇痛,病人控制%消耗量
右美託咪啶%舒芬太尼%鎮痛,病人控製%消耗量
우미탁미정%서분태니%진통,병인공제%소모량
Dexmedetomidine%Sufentanil%Analgesia,patient-controlled%Consumption
目的 探讨右美托咪定对舒芬太尼术后患者自控静脉镇痛(PCIA)消耗量的影响.方法 择期全身麻醉下经腹行全子宫切除术患者80例,ASA分级Ⅰ或Ⅱ级,按随机数字表法分为两组,每组40例,试验组在手术结束前1h缓慢泵入(10 min)右美托咪定0.6μg/kg,对照组给予相同体积0.9％氯化钠,连接舒芬太尼PCIA泵,舒芬太尼2μg/kg+托烷司琼5mg溶于0.9％氯化钠100 ml中,负荷剂量4 ml,背景剂量1 ml/h,自控剂量1 ml/h,锁定时间10 min.记录PCIA后1、2、6、12、24h的VAS评分、Ramsay镇静评分(RSS)和舒芬太尼累积消耗量；记录术后24 h内恶心、呕吐和寒战等发生情况.结果 PICA后各时点两组VAS评分和RSS比较差异无统计学意义(P＞0.05).试验组舒芬太尼累积消耗量PCIA后1、2、6、12、24h分别为(4.5±0.6)、(7.4±1.2)、(14.2±2.2)、(25.4±3.1)、(40.1±5.3)μg,明显少于对照组的(8.9±0.9)、(13.8±2.9)、(27.2±4.1)、(40.2±5.2)、(62.3±7.1) μg,差异有统计学意义(P＜0.05).试验组术后24 h内恶心、呕吐和寒战的发生率分别为7.5％(3/40)、2.5％(1/40)、2.5％(1/40),明显低于对照组的15.0％(6/40)、7.5％(3/40)、10.0％(4/40),差异有统计学意义(P＜0.05).结论 手术结束前1h缓慢泵入右美托咪定0.6μg/kg可减少术后舒芬太尼消耗量,并降低术后恶心、呕吐和寒战等不良反应.
目的 探討右美託咪定對舒芬太尼術後患者自控靜脈鎮痛(PCIA)消耗量的影響.方法 擇期全身痳醉下經腹行全子宮切除術患者80例,ASA分級Ⅰ或Ⅱ級,按隨機數字錶法分為兩組,每組40例,試驗組在手術結束前1h緩慢泵入(10 min)右美託咪定0.6μg/kg,對照組給予相同體積0.9％氯化鈉,連接舒芬太尼PCIA泵,舒芬太尼2μg/kg+託烷司瓊5mg溶于0.9％氯化鈉100 ml中,負荷劑量4 ml,揹景劑量1 ml/h,自控劑量1 ml/h,鎖定時間10 min.記錄PCIA後1、2、6、12、24h的VAS評分、Ramsay鎮靜評分(RSS)和舒芬太尼纍積消耗量；記錄術後24 h內噁心、嘔吐和寒戰等髮生情況.結果 PICA後各時點兩組VAS評分和RSS比較差異無統計學意義(P＞0.05).試驗組舒芬太尼纍積消耗量PCIA後1、2、6、12、24h分彆為(4.5±0.6)、(7.4±1.2)、(14.2±2.2)、(25.4±3.1)、(40.1±5.3)μg,明顯少于對照組的(8.9±0.9)、(13.8±2.9)、(27.2±4.1)、(40.2±5.2)、(62.3±7.1) μg,差異有統計學意義(P＜0.05).試驗組術後24 h內噁心、嘔吐和寒戰的髮生率分彆為7.5％(3/40)、2.5％(1/40)、2.5％(1/40),明顯低于對照組的15.0％(6/40)、7.5％(3/40)、10.0％(4/40),差異有統計學意義(P＜0.05).結論 手術結束前1h緩慢泵入右美託咪定0.6μg/kg可減少術後舒芬太尼消耗量,併降低術後噁心、嘔吐和寒戰等不良反應.
목적 탐토우미탁미정대서분태니술후환자자공정맥진통(PCIA)소모량적영향.방법 택기전신마취하경복행전자궁절제술환자80례,ASA분급Ⅰ혹Ⅱ급,안수궤수자표법분위량조,매조40례,시험조재수술결속전1h완만빙입(10 min)우미탁미정0.6μg/kg,대조조급여상동체적0.9％록화납,련접서분태니PCIA빙,서분태니2μg/kg+탁완사경5mg용우0.9％록화납100 ml중,부하제량4 ml,배경제량1 ml/h,자공제량1 ml/h,쇄정시간10 min.기록PCIA후1、2、6、12、24h적VAS평분、Ramsay진정평분(RSS)화서분태니루적소모량；기록술후24 h내악심、구토화한전등발생정황.결과 PICA후각시점량조VAS평분화RSS비교차이무통계학의의(P＞0.05).시험조서분태니루적소모량PCIA후1、2、6、12、24h분별위(4.5±0.6)、(7.4±1.2)、(14.2±2.2)、(25.4±3.1)、(40.1±5.3)μg,명현소우대조조적(8.9±0.9)、(13.8±2.9)、(27.2±4.1)、(40.2±5.2)、(62.3±7.1) μg,차이유통계학의의(P＜0.05).시험조술후24 h내악심、구토화한전적발생솔분별위7.5％(3/40)、2.5％(1/40)、2.5％(1/40),명현저우대조조적15.0％(6/40)、7.5％(3/40)、10.0％(4/40),차이유통계학의의(P＜0.05).결론 수술결속전1h완만빙입우미탁미정0.6μg/kg가감소술후서분태니소모량,병강저술후악심、구토화한전등불량반응.
Objective To investigate the effect of dexmedetomidine (Dex) on postoperative sufentanil consumption in patient-controlled intravenous analgesia (PCIA).Methods Eighty patients (ASA Ⅰ or Ⅱ) undergoing abdominal hysterectomy and general anesthesia were divided into 2 groups with 40 cases each by random digits table.Patients in experiment group were received Dex 0.6 μg/kg (in 10 minutes).Patients in control group were recieved normal saline respectively by pumped infusion one hour before the operation finishing.All patients received a standadized sufentanil PCIA one hour before the operation finishing,sufentanil 2 μg/kg in 100 ml saline with tropisetron 5 mg,the loading dose was 4 ml,the backgroud dose was 1 ml/h,the controlled dose was 1 ml/h,the lock time was 10 minutes.The scores of VAS and RSS were recorded 1,2,6,12 and 24 hours after PCIA,and the incidence rate of the nausea,vomiting and shivering were recorded too for 24 hours.Results There was no statistical significance between the two groups in the scores of VAS and RSS after PCIA.The sufentanil consumption 1,2,6,12 and 24 hours after PCIA in experiment group [(4.5 ± 0.6),(7.4 ± 1.2),(14.2 ± 2.2),(25.4 ± 3.1),(40.1 ± 5.3) μg] was less than that in control group [(8.9 ± 0.9),(13.8 ± 2.9),(27.2 ± 4.1),(40.2 ± 5.2),(62.3 ± 7.1) μg] (P ＜0.05).The incidence of postoperative nausea,vomiting and shivering in experiment group [7.5％(3/40),2.5％(1/40),2.5％(1/40)] was less than that in control group [15.0％(6/40),7.5％(3/40),10.0％(4/40)](P ＜ 0.05).Conclusion The patients receive Dex 0.6 μg/kg one hour before the operation finishing,need less consumption of sufentanil and occur less postoperative nausea,vomiting and shivering.
