中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2012年
24期
29-32
,共4页
右美托咪啶%舒芬太尼%镇痛%患者控制
右美託咪啶%舒芬太尼%鎮痛%患者控製
우미탁미정%서분태니%진통%환자공제
Dexmedetomidine%Sufentail%Analgesia%Patient-controlled
目的 观察右美托咪啶复合舒芬太尼用于开胸术后患者自控静脉镇痛(PCIA)的临床效果.方法 将60例行开胸肺叶切除或肺大疱切除术后PCIA的患者随机双盲分为三组,每组20例.A组使用舒芬太尼0.04μg/(kg·h),B组和C组分别使用舒芬太尼0.04 μg/(kg·h)加右美托咪啶0.07 μg/(kg·h)和0.10 μg/(kg·h),均以生理盐水稀释至100 ml.监测并记录PCIA后2、4、6、12、24h平均血压(MBP)、心率(HR)、动脉血氧饱和度(SpO2)、视觉模拟评分法(VAS评分)和Ramsay镇静评分、24 h内总按压次数、舒芬太尼用量及不良反应情况.结果 B、C组在不同时点MBP与A组比较差异均无统计学意义(P＞0.05),而HR在PCIA后4、6、12、24 h低于A组(P＜0.05),SpO2在4、6h高于A组(P＜0.05)；PCIA后4、6、12、24 h VAS评分C组＜B组＜A组,Ramsay评分C组＞B组＞A组(P＜0.05)；24 h内PCIA总按压次数、舒芬太尼用量及恶心、呕吐、皮肤瘙痒的发生率C组＜B组＜A组(P＜0.05).结论 右美托咪啶可增强开胸术后舒芬太尼PCIA的效果,减少舒芬太尼用量,降低不良反应发生率.
目的 觀察右美託咪啶複閤舒芬太尼用于開胸術後患者自控靜脈鎮痛(PCIA)的臨床效果.方法 將60例行開胸肺葉切除或肺大皰切除術後PCIA的患者隨機雙盲分為三組,每組20例.A組使用舒芬太尼0.04μg/(kg·h),B組和C組分彆使用舒芬太尼0.04 μg/(kg·h)加右美託咪啶0.07 μg/(kg·h)和0.10 μg/(kg·h),均以生理鹽水稀釋至100 ml.鑑測併記錄PCIA後2、4、6、12、24h平均血壓(MBP)、心率(HR)、動脈血氧飽和度(SpO2)、視覺模擬評分法(VAS評分)和Ramsay鎮靜評分、24 h內總按壓次數、舒芬太尼用量及不良反應情況.結果 B、C組在不同時點MBP與A組比較差異均無統計學意義(P＞0.05),而HR在PCIA後4、6、12、24 h低于A組(P＜0.05),SpO2在4、6h高于A組(P＜0.05)；PCIA後4、6、12、24 h VAS評分C組＜B組＜A組,Ramsay評分C組＞B組＞A組(P＜0.05)；24 h內PCIA總按壓次數、舒芬太尼用量及噁心、嘔吐、皮膚瘙癢的髮生率C組＜B組＜A組(P＜0.05).結論 右美託咪啶可增彊開胸術後舒芬太尼PCIA的效果,減少舒芬太尼用量,降低不良反應髮生率.
목적 관찰우미탁미정복합서분태니용우개흉술후환자자공정맥진통(PCIA)적림상효과.방법 장60례행개흉폐협절제혹폐대포절제술후PCIA적환자수궤쌍맹분위삼조,매조20례.A조사용서분태니0.04μg/(kg·h),B조화C조분별사용서분태니0.04 μg/(kg·h)가우미탁미정0.07 μg/(kg·h)화0.10 μg/(kg·h),균이생리염수희석지100 ml.감측병기록PCIA후2、4、6、12、24h평균혈압(MBP)、심솔(HR)、동맥혈양포화도(SpO2)、시각모의평분법(VAS평분)화Ramsay진정평분、24 h내총안압차수、서분태니용량급불량반응정황.결과 B、C조재불동시점MBP여A조비교차이균무통계학의의(P＞0.05),이HR재PCIA후4、6、12、24 h저우A조(P＜0.05),SpO2재4、6h고우A조(P＜0.05)；PCIA후4、6、12、24 h VAS평분C조＜B조＜A조,Ramsay평분C조＞B조＞A조(P＜0.05)；24 h내PCIA총안압차수、서분태니용량급악심、구토、피부소양적발생솔C조＜B조＜A조(P＜0.05).결론 우미탁미정가증강개흉술후서분태니PCIA적효과,감소서분태니용량,강저불량반응발생솔.
Objective To evaluate the effect of dexmedetomidine combined with sufentanil for patient-controlled intravenous analgesia (PCIA) after thoracotomy.Methods Sixty ASA Ⅰ or Ⅱ patients undering thoracotomy were randomly divided into 3 groups (20 cases in each group).Group A:sufentanil 0.04 μug/(kg · h).Group B:sufentanil 0.04 μug/(kg · h) + dexmedetomidine 0.07 μug/(kg · h).Group C:sufentanil 0.04 μg/(kg · h) + dexmedetomidine 0.10 μg/(kg · h).PCIA setting as follows:background infusion 2 ml/h and bolus dose 0.5 ml and lockout interva 10 mins.Mean artery pressure (MAP),HR,SpO2,VAS score and Ramsay sedation score were recorded at 2,4,6,12 and 24 hours after the beginning of PCIA.The number of successfully delivered doses and cumulative sufentanil consumption and side effects such as nausea and vomiting within 24 hours were also recorded.Results There were no differences among three groups in MAP at each time.HR and VAS score in group A were significantly higher than those in group B and C at 4,6,12 and 24 hours (P ＜ 0.05).Group C ＞ group B ＞ group A in ramsay scores at 4,6,12 and 24 hours (P ＜ 0.05).The number of successfully delivered doses and cumulative sufentaml consumption and side effects such as nausea and vomiting within 24 hours were group C ＜ group B ＜ group A (P ＜ 0.05).Conclusions Dexmedetomidine added to intravenous sufentanil PC A can improve the analgesic efficacy after thoracotomy with less adverse.
