中国实用医药
中國實用醫藥
중국실용의약
CHINA PRACTICAL MEDICAL
2015年
4期
20-21
,共2页
舒芬太尼%地佐辛%术后镇痛
舒芬太尼%地佐辛%術後鎮痛
서분태니%지좌신%술후진통
Sufentanil%Dezocine%Postoperative analgesia
目的：探讨舒芬太尼复合地佐辛应用于开胸手术患者术后自控静脉镇痛(PCIA)的效果。方法择期行开胸手术的患者120例，随机分为三组，每组40例，术后均行PCIA。镇痛药配方：A组，舒芬太尼复合地佐辛组，舒芬太尼1.25μg/kg+地佐辛0.4 mg/kg+昂丹司琼8 mg+生理盐水稀释至100 ml；B组，舒芬太尼组，舒芬太尼2.5μg/kg+昂丹司琼8 mg+生理盐水稀释至100 ml；C组，地佐辛组，地佐辛0.8 mg/kg +昂丹司琼8 mg+生理盐水稀释至100 ml。术中采用静吸复合全身麻醉，术毕接PCIA 镇痛。观察三组患者术后4、8、12、24、48 h 视觉模拟评分(VAS)、镇静程度评分(Ramsay)及不良反应的情况。结果在术后4、8、12 h 时间点C组VAS评分高于A组和B组(P<0.05)。术后4、8、12 h 时间点B组和C组Ramsay 评分高于A 组(P<0.05)。B组患者头晕嗜睡、恶心呕吐发生率明显高于A、C组(P<0.05)。结论舒芬太尼复合地佐辛可以安全有效地用于开胸手术术后镇痛，镇痛效果较好，不良反应少。
目的：探討舒芬太尼複閤地佐辛應用于開胸手術患者術後自控靜脈鎮痛(PCIA)的效果。方法擇期行開胸手術的患者120例，隨機分為三組，每組40例，術後均行PCIA。鎮痛藥配方：A組，舒芬太尼複閤地佐辛組，舒芬太尼1.25μg/kg+地佐辛0.4 mg/kg+昂丹司瓊8 mg+生理鹽水稀釋至100 ml；B組，舒芬太尼組，舒芬太尼2.5μg/kg+昂丹司瓊8 mg+生理鹽水稀釋至100 ml；C組，地佐辛組，地佐辛0.8 mg/kg +昂丹司瓊8 mg+生理鹽水稀釋至100 ml。術中採用靜吸複閤全身痳醉，術畢接PCIA 鎮痛。觀察三組患者術後4、8、12、24、48 h 視覺模擬評分(VAS)、鎮靜程度評分(Ramsay)及不良反應的情況。結果在術後4、8、12 h 時間點C組VAS評分高于A組和B組(P<0.05)。術後4、8、12 h 時間點B組和C組Ramsay 評分高于A 組(P<0.05)。B組患者頭暈嗜睡、噁心嘔吐髮生率明顯高于A、C組(P<0.05)。結論舒芬太尼複閤地佐辛可以安全有效地用于開胸手術術後鎮痛，鎮痛效果較好，不良反應少。
목적：탐토서분태니복합지좌신응용우개흉수술환자술후자공정맥진통(PCIA)적효과。방법택기행개흉수술적환자120례，수궤분위삼조，매조40례，술후균행PCIA。진통약배방：A조，서분태니복합지좌신조，서분태니1.25μg/kg+지좌신0.4 mg/kg+앙단사경8 mg+생리염수희석지100 ml；B조，서분태니조，서분태니2.5μg/kg+앙단사경8 mg+생리염수희석지100 ml；C조，지좌신조，지좌신0.8 mg/kg +앙단사경8 mg+생리염수희석지100 ml。술중채용정흡복합전신마취，술필접PCIA 진통。관찰삼조환자술후4、8、12、24、48 h 시각모의평분(VAS)、진정정도평분(Ramsay)급불량반응적정황。결과재술후4、8、12 h 시간점C조VAS평분고우A조화B조(P<0.05)。술후4、8、12 h 시간점B조화C조Ramsay 평분고우A 조(P<0.05)。B조환자두훈기수、악심구토발생솔명현고우A、C조(P<0.05)。결론서분태니복합지좌신가이안전유효지용우개흉수술술후진통，진통효과교호，불량반응소。
Objective To explore the effect of sufentanil combined with dezocine applied in postoperative patient controlled intravenous analgesia (PCIA) for patients undergoing thoracotomy.Methods A total of 120 patients, who underwent thoracotomy, were randomly divided into three group with 40 cases in each group. They all received PCIA. The analgesic formula for group A, as sufentanil combined with dezocine group, was sufentanil 1.25μg/kg + dezocine 0.4 mg/kg+ondansetron 8 mg, diluted to 100 ml by normal saline; that for group B, as sufentanil group, was sufentanil 2.5μg/kg+ondansetron 8 mg, diluted to 100 ml by normal saline; and that for group C, as dezocine group, was dezocine 0.8 mg/kg+ondansetron 8 mg, diluted to 100 ml by normal saline. Intravenous inhalation anesthesia and general anesthesia were applied during surgery and PCIA after surgery. Visual analogue scale (VAS), degree of sedation scores (Ramsay), and adverse reactions were observed in 4 h, 8 h, 12 h, 24 h, and 48 h after surgery in the three groups.Results In postoperative 4 h, 8 h and 12 h, group C had higher VAS score than groups A and B (P<0.05), and groups B and C had higher Ramsay scores than group A (P<0.05). Group B had higher incidences of drowsiness, dizziness, nausea, and emesis than groups A and C (P<0.05).Conclusion Sufentanil combined with dezocine in PCIA for thoracotomy is safe and effective, with good analgesic effect and few adverse reactions.
