广西医学
廣西醫學
엄서의학
GUANGXI MEDICAL JOURNAL
2015年
2期
163-165
,共3页
开腹手术%自控静脉镇痛%芬太尼%耐痛阈
開腹手術%自控靜脈鎮痛%芬太尼%耐痛閾
개복수술%자공정맥진통%분태니%내통역
Laparotomy%Patient-controlled intravenous analgesia%Fentanyl%Pain tolerance
目的：探讨成人开腹手术术后静脉自控镇痛芬太尼消耗量的影响因素，为术后自控镇痛个体化给药提供临床参考。方法择期行全麻开腹手术并同意术后使用静脉自控镇痛的患者80例。术前测量患者的痛阈、耐痛阈并评价其焦虑水平。麻醉均采用气管插管全凭静脉麻醉。手术结束时记录患者性别、年龄、身高、体重、手术种类和手术时间，测量手术切口大小。术毕行静脉自控镇痛，镇痛泵药物配方为芬太尼1 mg＋氟哌利多5 mg＋生理盐水稀释至150 ml。于镇痛泵开启后第4小时、8小时、16小时、24小时进行随访，观察记录疼痛视觉模拟评分、镇静程度评分及芬太尼消耗量，并计算体表面积。将患者性别、年龄、体表面积、痛阈、耐痛阈、状态焦虑评分、特质焦虑评分、手术种类、手术时间、切口大小与24 h芬太尼消耗量行Stepwise多重线性回归分析。结果性别、体表面积、痛阈、状态焦虑评分、特质焦虑评分、手术种类以及切口大小对芬太尼消耗量影响无统计学意义（P＞0．05），年龄、耐痛阈和手术时间对芬太尼消耗量影响有统计学意义（P＜0．05）。回归方程：芬太尼消耗量＝617．82－36．13×耐痛阈－1．25×年龄＋0．59×手术时间。结论耐痛阈、年龄和手术时间是成人开腹手术术后静脉自控镇痛芬太尼消耗量的影响因素。
目的：探討成人開腹手術術後靜脈自控鎮痛芬太尼消耗量的影響因素，為術後自控鎮痛箇體化給藥提供臨床參攷。方法擇期行全痳開腹手術併同意術後使用靜脈自控鎮痛的患者80例。術前測量患者的痛閾、耐痛閾併評價其焦慮水平。痳醉均採用氣管插管全憑靜脈痳醉。手術結束時記錄患者性彆、年齡、身高、體重、手術種類和手術時間，測量手術切口大小。術畢行靜脈自控鎮痛，鎮痛泵藥物配方為芬太尼1 mg＋氟哌利多5 mg＋生理鹽水稀釋至150 ml。于鎮痛泵開啟後第4小時、8小時、16小時、24小時進行隨訪，觀察記錄疼痛視覺模擬評分、鎮靜程度評分及芬太尼消耗量，併計算體錶麵積。將患者性彆、年齡、體錶麵積、痛閾、耐痛閾、狀態焦慮評分、特質焦慮評分、手術種類、手術時間、切口大小與24 h芬太尼消耗量行Stepwise多重線性迴歸分析。結果性彆、體錶麵積、痛閾、狀態焦慮評分、特質焦慮評分、手術種類以及切口大小對芬太尼消耗量影響無統計學意義（P＞0．05），年齡、耐痛閾和手術時間對芬太尼消耗量影響有統計學意義（P＜0．05）。迴歸方程：芬太尼消耗量＝617．82－36．13×耐痛閾－1．25×年齡＋0．59×手術時間。結論耐痛閾、年齡和手術時間是成人開腹手術術後靜脈自控鎮痛芬太尼消耗量的影響因素。
목적：탐토성인개복수술술후정맥자공진통분태니소모량적영향인소，위술후자공진통개체화급약제공림상삼고。방법택기행전마개복수술병동의술후사용정맥자공진통적환자80례。술전측량환자적통역、내통역병평개기초필수평。마취균채용기관삽관전빙정맥마취。수술결속시기록환자성별、년령、신고、체중、수술충류화수술시간，측량수술절구대소。술필행정맥자공진통，진통빙약물배방위분태니1 mg＋불고리다5 mg＋생리염수희석지150 ml。우진통빙개계후제4소시、8소시、16소시、24소시진행수방，관찰기록동통시각모의평분、진정정도평분급분태니소모량，병계산체표면적。장환자성별、년령、체표면적、통역、내통역、상태초필평분、특질초필평분、수술충류、수술시간、절구대소여24 h분태니소모량행Stepwise다중선성회귀분석。결과성별、체표면적、통역、상태초필평분、특질초필평분、수술충류이급절구대소대분태니소모량영향무통계학의의（P＞0．05），년령、내통역화수술시간대분태니소모량영향유통계학의의（P＜0．05）。회귀방정：분태니소모량＝617．82－36．13×내통역－1．25×년령＋0．59×수술시간。결론내통역、년령화수술시간시성인개복수술술후정맥자공진통분태니소모량적영향인소。
Objective To explore the influence factors for fentanyl consumption of patient-controlled analgesia after adult laparotomy to provide clinical references for the individual medication of postoperative patient -controlled analgesia .Methods Eighty patients who underwent selective laparotomy with general anesthesia and agreed to the use of patient-controlled intravenous analgesia after operation were enrolled in the study .The patient′s pain threshold and pain tolerance were measured before operation to evaluate their anxiety level .Total intravenous anesthesia with tracheal intubation was performed .The patient′s gender,age,body height,body weight,type of operation and operation duration were recorded at the end of operation ,and the length of operative incision was measured .Postoperative analgesia pump for patient-controlled intravenous analgesia was performed after operation ,with a drug formulation of dilute solution (150 ml) of fentanyl(1 mg), droperidol(5 mg) and normal saline.The follow up was performed on the 4th,8th,16th and 24th hour after analgesia pump worked .The visual analogue scale(VAS) score,Ramsay score and fentanyl consumption were observed and recorded ,and the body surface area was calculated.The patient′s gender,age,body surface area,pain threshold,pain tolerance,state anxiety score,trait anxiety score,type of operation, operation duration,length of incision and 24-hour fentanyl consumption were analyzed in Stepwise multiple linear regression .Results The effects of gender,body surface area,pain threshold,state anxiety score,trait anxiety score,type of operation and length of incision on fentanyl consumption showed no statistical significance(P>0.05),while the effects of age,pain tolerance and operation duration on fentanyl consumption showed a statistical significance(P<0.05).The regression equation:fentanyl consumption =617.82-36.13 ×pain tolerance-1.25 ×age+0.59 ×operation duration.Conclusion Pain tolerance,age and operation duration are the influencing factors for fentanyl consumption of patient -controlled intravenous analgesia after adult laparotomy .
