吉林医学
吉林醫學
길림의학
JILIN MEDICAL JOURANL
2014年
19期
4193-4194,4195
,共3页
芬太尼%曲马多%镇痛
芬太尼%麯馬多%鎮痛
분태니%곡마다%진통
Fentanyl%Tramadol%Analgesia
目的：研究并讨论芬太尼PCSA与曲马多在心外科手术后的镇痛机制、临床疗效和安全性。方法：在ASA Ⅰ~Ⅲ级的心外科术后患者中抽取40例，将其分为芬太尼组和曲马多组各20例。芬太尼组的患者在心外科手术后给予利多卡因和芬太尼进行镇痛，曲马多组患者在心外科术后给予利多卡因和曲马多进行镇痛。PCA设置：单次剂量为1 ml，负荷量2 ml，限量是8 ml，其锁定时间为5 min。将药物在负荷量范围内注射完毕后开始记录的时间即为起效时间，同时记录气管导管拔除后12 h、24 h、36 h和48 h时间点的各项指标。结果：曲马多组镇痛的起效时间、有效按压次数和术后12 h的药物使用量均高于芬太尼组，差异有统计学意义（ P﹤0.05）。但两组患者对术后镇痛评价的满意度和术后24 h、48 h的有效按压次数间比较，差异无统计学意义（ P>0.05）。结论：芬太尼PCSA与曲马多在心外科手术后的镇痛疗效无明显的差异，但在手术结束的初始阶段，曲马多镇痛药物的消耗量显著多于芬太尼，且其不良反应也大于芬太尼，为降低不良反应多次少剂量注射曲马多镇痛药。
目的：研究併討論芬太尼PCSA與麯馬多在心外科手術後的鎮痛機製、臨床療效和安全性。方法：在ASA Ⅰ~Ⅲ級的心外科術後患者中抽取40例，將其分為芬太尼組和麯馬多組各20例。芬太尼組的患者在心外科手術後給予利多卡因和芬太尼進行鎮痛，麯馬多組患者在心外科術後給予利多卡因和麯馬多進行鎮痛。PCA設置：單次劑量為1 ml，負荷量2 ml，限量是8 ml，其鎖定時間為5 min。將藥物在負荷量範圍內註射完畢後開始記錄的時間即為起效時間，同時記錄氣管導管拔除後12 h、24 h、36 h和48 h時間點的各項指標。結果：麯馬多組鎮痛的起效時間、有效按壓次數和術後12 h的藥物使用量均高于芬太尼組，差異有統計學意義（ P﹤0.05）。但兩組患者對術後鎮痛評價的滿意度和術後24 h、48 h的有效按壓次數間比較，差異無統計學意義（ P>0.05）。結論：芬太尼PCSA與麯馬多在心外科手術後的鎮痛療效無明顯的差異，但在手術結束的初始階段，麯馬多鎮痛藥物的消耗量顯著多于芬太尼，且其不良反應也大于芬太尼，為降低不良反應多次少劑量註射麯馬多鎮痛藥。
목적：연구병토론분태니PCSA여곡마다재심외과수술후적진통궤제、림상료효화안전성。방법：재ASA Ⅰ~Ⅲ급적심외과술후환자중추취40례，장기분위분태니조화곡마다조각20례。분태니조적환자재심외과수술후급여리다잡인화분태니진행진통，곡마다조환자재심외과술후급여리다잡인화곡마다진행진통。PCA설치：단차제량위1 ml，부하량2 ml，한량시8 ml，기쇄정시간위5 min。장약물재부하량범위내주사완필후개시기록적시간즉위기효시간，동시기록기관도관발제후12 h、24 h、36 h화48 h시간점적각항지표。결과：곡마다조진통적기효시간、유효안압차수화술후12 h적약물사용량균고우분태니조，차이유통계학의의（ P﹤0.05）。단량조환자대술후진통평개적만의도화술후24 h、48 h적유효안압차수간비교，차이무통계학의의（ P>0.05）。결론：분태니PCSA여곡마다재심외과수술후적진통료효무명현적차이，단재수술결속적초시계단，곡마다진통약물적소모량현저다우분태니，차기불량반응야대우분태니，위강저불량반응다차소제량주사곡마다진통약。
Objective To study and discuss the mechanism of fentanyl analgesic tramadol PCSA and after cardiac surgery,clinical effi-cacy and safety. Method To extract cardiac surgery patients ASAⅠ~Ⅲ level in 40 cases,were divided into groups and fentanyl tramadol group 20 cases. Fentanyl group of patients after cardiac surgery patients were given the drug lidocaine and fentanyl analgesia,tramadol in patients after cardiac surgery patients were given the drug lidocaine and tramadol analgesia. PCA settings:a single dose of 1ml,load 2 ml, limit was 8 ml,lock time was 5 min. After completion of drug injection in the load range starts recording time was the onset time,while re-cording 12 h,24 h,36 h and 48 h of the indicators point in time after extubation. Results The analgesic tramadol group onset time,effective compressions and drug use were higher than after 12 h of fentanyl group,There were significant differences between the two groups( P﹤0. 05 ),there were statistically significant. However,no significant difference between the two groups of patients satisfaction and postoperative evaluation of postoperative analgesia effective compression 24,48 h,so no statistical significance(P>0. 05). Conclusion PCSA with fenta-nyl tramadol is not significant difference in heart analgesic efficacy after surgery,but in the initial stages of the end of surgery,the analgesic tramadol consumption was significantly greater than fentanyl,and its side effects is also greater than fentanyl,to reduce side effects of re-peated low -dose injection should tramadol analgesics.
