北方药学
北方藥學
북방약학
JOURNAL OF NORTH PHARMACY
2015年
6期
121-121,122
,共2页
史丽莉%吕秀云%张怡%李纯珠
史麗莉%呂秀雲%張怡%李純珠
사려리%려수운%장이%리순주
患者自控镇痛%硬膜外%吗啡%芬太尼
患者自控鎮痛%硬膜外%嗎啡%芬太尼
환자자공진통%경막외%마배%분태니
The patient controlled analgesia%Epidural%Morphine%Fentanyl
目的：观察术后硬膜外和静脉联合镇痛的效果和不良反应。方法：连续硬膜外麻醉下行腹式全子宫切除术120例，随机分为I、II、III组，I、III组术毕经硬膜外腔给予吗啡1mg+甲氧氯普胺10mg+生理盐水至5ml；I组术后硬膜外镇痛（PCEA）用药为吗啡4mg+甲氧氯普胺30mg+生理盐水至100ml；II组手术结束前给予负荷量芬太尼0.1mg静脉注射，术后静脉镇痛（PCIA）用药为芬太尼0.015mg/kg+甲氧氯普胺30mg+生理盐水至100ml；III组术后PCIA为芬太尼0.01mg/kg+甲氧氯普胺30mg+生理盐水至100ml。观察记录各组术后4h、8h、16h、24h、32h的疼痛VAS评分和镇痛泵按压（PCA）次数及不良反应。结果：I组、III组镇痛效果好，II组比I组、III组稍差，I组、II组副作用与III组比明显增多（P＜0.05）。 III组术后各时点VAS评分最低，用药量小，副作用少。结论：联合镇痛能达到镇痛目的，起到阶梯用药的作用，减少用药量，减轻药物引起的副作用。
目的：觀察術後硬膜外和靜脈聯閤鎮痛的效果和不良反應。方法：連續硬膜外痳醉下行腹式全子宮切除術120例，隨機分為I、II、III組，I、III組術畢經硬膜外腔給予嗎啡1mg+甲氧氯普胺10mg+生理鹽水至5ml；I組術後硬膜外鎮痛（PCEA）用藥為嗎啡4mg+甲氧氯普胺30mg+生理鹽水至100ml；II組手術結束前給予負荷量芬太尼0.1mg靜脈註射，術後靜脈鎮痛（PCIA）用藥為芬太尼0.015mg/kg+甲氧氯普胺30mg+生理鹽水至100ml；III組術後PCIA為芬太尼0.01mg/kg+甲氧氯普胺30mg+生理鹽水至100ml。觀察記錄各組術後4h、8h、16h、24h、32h的疼痛VAS評分和鎮痛泵按壓（PCA）次數及不良反應。結果：I組、III組鎮痛效果好，II組比I組、III組稍差，I組、II組副作用與III組比明顯增多（P＜0.05）。 III組術後各時點VAS評分最低，用藥量小，副作用少。結論：聯閤鎮痛能達到鎮痛目的，起到階梯用藥的作用，減少用藥量，減輕藥物引起的副作用。
목적：관찰술후경막외화정맥연합진통적효과화불량반응。방법：련속경막외마취하행복식전자궁절제술120례，수궤분위I、II、III조，I、III조술필경경막외강급여마배1mg+갑양록보알10mg+생리염수지5ml；I조술후경막외진통（PCEA）용약위마배4mg+갑양록보알30mg+생리염수지100ml；II조수술결속전급여부하량분태니0.1mg정맥주사，술후정맥진통（PCIA）용약위분태니0.015mg/kg+갑양록보알30mg+생리염수지100ml；III조술후PCIA위분태니0.01mg/kg+갑양록보알30mg+생리염수지100ml。관찰기록각조술후4h、8h、16h、24h、32h적동통VAS평분화진통빙안압（PCA）차수급불량반응。결과：I조、III조진통효과호，II조비I조、III조초차，I조、II조부작용여III조비명현증다（P＜0.05）。 III조술후각시점VAS평분최저，용약량소，부작용소。결론：연합진통능체도진통목적，기도계제용약적작용，감소용약량，감경약물인기적부작용。
Objective:To observe the postoperative epidural and intravenous analgesia effect and adverse reactions. Methods:Continuous epidural anesthesia downlink total abdominal hysterectomy for 120 cases were randomly divided into group I, II, III, Group I and III is given the epidural injection with morphine 1 mg + Metoclopramide 10mg + 0.9%N.S to 5ml at the end of the surgery; Group I of postoperative epidural analgesia (PCEA) used with morphine 4mg+Metoclopramide 30 mg+0.9%N.S to 100ml;Group II is given load 0.1mg fentanyl iv before the end of the surgery, postoperative intravenous analgesia (PCIA)used with fentanyl 0.015mg/kg +Metoclopramide 30mg + 0.9%N.S to 100 ml; Group III used with 0.01 mg/ kg fentanyl+ Metoclopramide 30 mg +0.9%N.S to 100ml. Observe and record each postoperative, 4, 8, 16, 24, 32h VAS score and the number of analgesia (PCA) pump compressions and adverse reactions. Results: Group I and III analgesic effect is good, group II is a bit poor than Group I and III, side effects of Group I and II was obviously more than group III(P<0.05). Group III has the lowest score of VAS, small dose, less side effects. Conclusions:Combined analgesia can achieve analgesia, have the effect of ladder drug use, reduce the dose, reduce the side effects of drugs.
