中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2013年
27期
33-35
,共3页
镇痛,病人控制%右美托咪啶%布托啡诺%乳腺癌根治术
鎮痛,病人控製%右美託咪啶%佈託啡諾%乳腺癌根治術
진통,병인공제%우미탁미정%포탁배낙%유선암근치술
Analgesia,patient-controlled%Dexmedetomidine%Butorphanol%Radical mastectomy
目的 观察低剂量右美托咪定复合酒石酸布托啡诺用于乳腺癌根治术后患者自控静脉镇痛(PCIA)的临床效果.方法 选择美国麻醉师协会(ASA)分级Ⅰ～Ⅱ级,拟行乳腺癌根治术的女性患者70例,按随机数字表法分为单纯酒石酸布托啡诺组(B组)和低剂量右美托咪定与酒石酸布托啡诺联合用药组(DB组),每组35例.采用疼痛视觉模拟量表(VAS)评分法(0～10分)比较两组术后24、48 h患者的疼痛评分,记录各时间段患者Ramsay镇静评分、酒石酸布托啡诺消耗量、哌替啶肌肉注射次数及恶心呕吐、头晕、呼吸抑制等不良反应发生率.结果 两组患者均取得较好的镇痛效果,VAS评分均小于4分,且DB组患者术后24、48 h VAS评分均低于B组[(3.2±0.3)分比(3.8±0.4)分、(2.7±0.3)分比(3.2±0.2)分],差异有统计学意义(P＜0.05).两组患者术后24、48 h Ramsay镇静评分比较差异无统计学意义(P＞0.05).DB组患者酒石酸布托啡诺消耗量、哌替啶肌肉注射次数均少于B组[(6.2±1.3)mg比(7.8±1.6)mg、(2.3±1.8)次比(5.3±2.1)次],差异有统计学意义(P＜0.05).结论 低剂量右美托咪定可提高乳腺癌根治术后酒石酸布托啡诺的PCIA效果,并有助于减少酒石酸布托啡诺消耗量和不良反应发生率.
目的 觀察低劑量右美託咪定複閤酒石痠佈託啡諾用于乳腺癌根治術後患者自控靜脈鎮痛(PCIA)的臨床效果.方法 選擇美國痳醉師協會(ASA)分級Ⅰ～Ⅱ級,擬行乳腺癌根治術的女性患者70例,按隨機數字錶法分為單純酒石痠佈託啡諾組(B組)和低劑量右美託咪定與酒石痠佈託啡諾聯閤用藥組(DB組),每組35例.採用疼痛視覺模擬量錶(VAS)評分法(0～10分)比較兩組術後24、48 h患者的疼痛評分,記錄各時間段患者Ramsay鎮靜評分、酒石痠佈託啡諾消耗量、哌替啶肌肉註射次數及噁心嘔吐、頭暈、呼吸抑製等不良反應髮生率.結果 兩組患者均取得較好的鎮痛效果,VAS評分均小于4分,且DB組患者術後24、48 h VAS評分均低于B組[(3.2±0.3)分比(3.8±0.4)分、(2.7±0.3)分比(3.2±0.2)分],差異有統計學意義(P＜0.05).兩組患者術後24、48 h Ramsay鎮靜評分比較差異無統計學意義(P＞0.05).DB組患者酒石痠佈託啡諾消耗量、哌替啶肌肉註射次數均少于B組[(6.2±1.3)mg比(7.8±1.6)mg、(2.3±1.8)次比(5.3±2.1)次],差異有統計學意義(P＜0.05).結論 低劑量右美託咪定可提高乳腺癌根治術後酒石痠佈託啡諾的PCIA效果,併有助于減少酒石痠佈託啡諾消耗量和不良反應髮生率.
목적 관찰저제량우미탁미정복합주석산포탁배낙용우유선암근치술후환자자공정맥진통(PCIA)적림상효과.방법 선택미국마취사협회(ASA)분급Ⅰ～Ⅱ급,의행유선암근치술적녀성환자70례,안수궤수자표법분위단순주석산포탁배낙조(B조)화저제량우미탁미정여주석산포탁배낙연합용약조(DB조),매조35례.채용동통시각모의량표(VAS)평분법(0～10분)비교량조술후24、48 h환자적동통평분,기록각시간단환자Ramsay진정평분、주석산포탁배낙소모량、고체정기육주사차수급악심구토、두훈、호흡억제등불량반응발생솔.결과 량조환자균취득교호적진통효과,VAS평분균소우4분,차DB조환자술후24、48 h VAS평분균저우B조[(3.2±0.3)분비(3.8±0.4)분、(2.7±0.3)분비(3.2±0.2)분],차이유통계학의의(P＜0.05).량조환자술후24、48 h Ramsay진정평분비교차이무통계학의의(P＞0.05).DB조환자주석산포탁배낙소모량、고체정기육주사차수균소우B조[(6.2±1.3)mg비(7.8±1.6)mg、(2.3±1.8)차비(5.3±2.1)차],차이유통계학의의(P＜0.05).결론 저제량우미탁미정가제고유선암근치술후주석산포탁배낙적PCIA효과,병유조우감소주석산포탁배낙소모량화불량반응발생솔.
Objective To observe the clinical effect of low-dose dexmedetomidine combined with butorphanol tartrate for patient controlled intravenous analgesia (PCIA) after radical mastectomy.Methods Seventy patients who ASA classification Ⅰ-Ⅱ grades with elective radical mastectomy were divided into the butorphanol tartrate PCIA group (group B),and the dexmedetomidine combined with butorphanol tartrate PCIA group (group DB) with 35 cases each by to random digits table method.To compare two groups of 24 h and 48 h after surgery in patients with pain score by visual analog scale (VAS) scores (0-10 scores).The Ramsay scores and the butorphanol consumption,intramuscular pethidine times were recorded in two groups.And the adverse events such as nausea and vomiting,dizziness and respiratory depression were observed.Results All patients got good analgesia in two groups,VAS scores ＜ 4 scores.VAS scores at 24,48 h after operation in group DB were lower than those in group B [(3.2 ± 0.3) scores vs.(3.8 ± 0.4) scores,(2.7 ± 0.3) scores vs.(3.2 ±0.2) scores],there were significant differences (P ＜0.05),while there was no significant difference of Ramsay scores between two groups(P＞ 0.05).And the butorphanol consumption and the intramuscular pethidine times in group DB were less than those in group B [(6.2±1.3)mgvs.(7.8± 1.6) mg,(2.3 ±1.8) times vs.(5.3 ±2.1) times],there were significant differences (P ＜0.05).Conclusion Low-dose dexmedetomidine may improve the effect of butorphanol tartrate PCIA after radical mastectomy,and help to reduce the butorphanol tartrate consumption and adverse effects.
