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
2014年
5期
411-413,418
,共4页
右美托咪定%地佐辛%镇痛%患者自控
右美託咪定%地佐辛%鎮痛%患者自控
우미탁미정%지좌신%진통%환자자공
Dexmedetomidine%Dezocine%Analgesia%Patient-controlled
目的 探讨右美托咪定(dexmedetomidine,Dex)对子宫切除术后地佐辛患者自控静脉镇痛效果的影响. 方法 择期拟行经腹子宫切除术的患者60例,年龄40岁～65岁,身高155 cm～170 cm,体重49 kg～75 kg,美国麻醉医师学会(ASA)分级Ⅰ或Ⅱ级,采用随机数字表法分为两组(每组30例):地佐辛组(D组)、Dex和地佐辛组(DD组).DD组术毕前30 min缓慢静脉泵注(15 min)Dex 0.8 μg/kg,D组静脉给予同等容量的生理盐水.两组均在术毕前10 min静脉注射地佐辛5 mg、托烷司琼2 mg,手术结束后行地佐辛患者自控静脉镇痛,地佐辛30 mg、托烷司琼8 mg用生理盐水稀释至150 ml,背景输注速率3 ml/h,自控给药剂量3 ml,锁定时间15 min.于术后4、8、24、48 h记录视觉模拟评分(viaual analogue scale,VAS)、镇静评分(ramsaysedation scores)、追加镇痛药例数、镇痛泵按压次数;记录术后48 h内恶心、呕吐、瘙痒、心动过缓、低血压和呼吸抑制等副作用发生情况. 结果 DD组术后4、8 h VAS评分[2(1～2)、2(1～2)]和镇痛泵按压次数[1(0～1)、0(0～1)]均低于同时点D组[3(2～3)、2(2～3)]和[1(1～2)、1(0～2)](P＜0.05).DD组术后48 h内恶心、呕吐的发生率3％、0％明显低于D组10％、3％(P＜0.05). 结论 术毕前30 min缓慢静脉泵注(15 min)Dex 0.8 μg/kg可增强地佐辛患者自控静脉镇痛效果,且副作用少.
目的 探討右美託咪定(dexmedetomidine,Dex)對子宮切除術後地佐辛患者自控靜脈鎮痛效果的影響. 方法 擇期擬行經腹子宮切除術的患者60例,年齡40歲～65歲,身高155 cm～170 cm,體重49 kg～75 kg,美國痳醉醫師學會(ASA)分級Ⅰ或Ⅱ級,採用隨機數字錶法分為兩組(每組30例):地佐辛組(D組)、Dex和地佐辛組(DD組).DD組術畢前30 min緩慢靜脈泵註(15 min)Dex 0.8 μg/kg,D組靜脈給予同等容量的生理鹽水.兩組均在術畢前10 min靜脈註射地佐辛5 mg、託烷司瓊2 mg,手術結束後行地佐辛患者自控靜脈鎮痛,地佐辛30 mg、託烷司瓊8 mg用生理鹽水稀釋至150 ml,揹景輸註速率3 ml/h,自控給藥劑量3 ml,鎖定時間15 min.于術後4、8、24、48 h記錄視覺模擬評分(viaual analogue scale,VAS)、鎮靜評分(ramsaysedation scores)、追加鎮痛藥例數、鎮痛泵按壓次數;記錄術後48 h內噁心、嘔吐、瘙癢、心動過緩、低血壓和呼吸抑製等副作用髮生情況. 結果 DD組術後4、8 h VAS評分[2(1～2)、2(1～2)]和鎮痛泵按壓次數[1(0～1)、0(0～1)]均低于同時點D組[3(2～3)、2(2～3)]和[1(1～2)、1(0～2)](P＜0.05).DD組術後48 h內噁心、嘔吐的髮生率3％、0％明顯低于D組10％、3％(P＜0.05). 結論 術畢前30 min緩慢靜脈泵註(15 min)Dex 0.8 μg/kg可增彊地佐辛患者自控靜脈鎮痛效果,且副作用少.
목적 탐토우미탁미정(dexmedetomidine,Dex)대자궁절제술후지좌신환자자공정맥진통효과적영향. 방법 택기의행경복자궁절제술적환자60례,년령40세～65세,신고155 cm～170 cm,체중49 kg～75 kg,미국마취의사학회(ASA)분급Ⅰ혹Ⅱ급,채용수궤수자표법분위량조(매조30례):지좌신조(D조)、Dex화지좌신조(DD조).DD조술필전30 min완만정맥빙주(15 min)Dex 0.8 μg/kg,D조정맥급여동등용량적생리염수.량조균재술필전10 min정맥주사지좌신5 mg、탁완사경2 mg,수술결속후행지좌신환자자공정맥진통,지좌신30 mg、탁완사경8 mg용생리염수희석지150 ml,배경수주속솔3 ml/h,자공급약제량3 ml,쇄정시간15 min.우술후4、8、24、48 h기록시각모의평분(viaual analogue scale,VAS)、진정평분(ramsaysedation scores)、추가진통약례수、진통빙안압차수;기록술후48 h내악심、구토、소양、심동과완、저혈압화호흡억제등부작용발생정황. 결과 DD조술후4、8 h VAS평분[2(1～2)、2(1～2)]화진통빙안압차수[1(0～1)、0(0～1)]균저우동시점D조[3(2～3)、2(2～3)]화[1(1～2)、1(0～2)](P＜0.05).DD조술후48 h내악심、구토적발생솔3％、0％명현저우D조10％、3％(P＜0.05). 결론 술필전30 min완만정맥빙주(15 min)Dex 0.8 μg/kg가증강지좌신환자자공정맥진통효과,차부작용소.
Objective To evaluate the effect of dexmedetomidine (Dex) on postoperative pain in patients receiving patient controlled intravenous analgesia with dezocine after hysterectomy.Methods Sixty ASA Ⅰ or Ⅱ patients undergoing elective abdominal hysterectomy,aged 40 y-65 y,weighing 49 kg-75 kg were randomly divided into 2 groups (n=30):group dezocine (group D),group Dex and dezocine (group DD).Dezocine 5 mg and tropisetron 2 mg were given in both groups at 10 min before the end of the operation.Patient controlled intravenous analgesia was performed with dezocine 30 mg+tropisetron 8 mg in 150 ml of normal saline after operation (background infusion at 3 ml/h with a bolus dose of 3 ml and a 15 min lockout interval).Dex 0.8μg/kg was given in 15 min in group DD by pumped infusion 30 min before the operation finished,while normal saline was given in group D.Viaual analogue scale (VAS),Ramsay sedation scores,the number of patiengs requiring rescue analgesics and the number of pressing the patient controlled intravenous analgesia button were recorded at 4,8,24,48 h after operation.Postoperative complications including nausea,vomiting,itching,bradycardia,hypotension,and respiratory depression were recorded.Results The VAS scores and times of pressing the patient controlled intravenous analgesia button were lower at 4 h and 8 h after surgery in group DD [2(1-2),2(1-2)] and [1(0-1),0(0-1)] than in group D [3(2-3),2(2-3)] and [1(1-2),1(0-2)](P＜0.05).The incidence of nausea and vomiting in group DD [3％,0％] was less than the group D [10％,3％] after surgery (P＜0.05).Conclusions Dex with a single dose of 0.8 μg/kg (given 15 min by pumped infusion) 30 min before operation finished can significantly improve the postoperative analgesic effect of patient controlled intravenous analgesia with dezocine with less adverse effects.
