摘要
目的观察骨科手术病人不同时机舒芬太尼病人自控静脉镇痛(PCIA)术后镇痛的效果及不良反应,以探讨舒芬太尼超前镇痛的有效性和安全性。方法择期骨科全麻术后舒芬太尼PCIA病人60例,随机平均分为3组:超前镇痛Ⅰ组(PⅠ组),麻醉诱导前5min静注舒芬太尼0.08μg/kg,手术结束前30min开始PCIA;超前镇痛Ⅱ组(PⅡ组),手术结束前30min开始PCIA;对照组(C组),手术结束拔管后开始PCIA。记录术后1,4,24和48h的疼痛评分、镇静评分、舒芬太尼用量、病人自控镇痛(PCA)总按压次数、PCA有效按压次数、并发症和病人满意度等。结果术后1h,PⅠ组和PⅡ组疼痛评分明显低于C组(P<0.05),PⅠ组镇静评分明显高于C组(P<0.05)。舒芬太尼用量PⅠ组、PⅡ组、C组依次增多,PCA总按压次数PⅠ组少于PⅡ组和C组(P<0.05),PⅠ组腹胀和尿潴留发生率低于C组(P<0.05)。术后72h病人满意率PI组明显高于C组(P<0.05)。结论麻醉诱导前5min静注舒芬太尼0.08μg/kg、手术结束前30min开始舒芬太尼PCIA的超前镇痛与术后开始的PCIA相比,镇痛效果更好,药物用量和不良反应明显减少。
Objective To investigate the clinical efficacy and safety of sufentanil on preemptive analgesia in patients undergoing orthopedic surgery. Methods Sixty orthopedic PCIA patients were randomly divided into three groups. In group P Ⅰ , sulfentanil 0.08 μg/kg was injected before anesthesia induction and PCIA was started 30 rain before the end of operation;in group P Ⅱ , PCIA was started 30 min befnre the end of operation; in gronp C, PCIA was started after extubation. Visual analogue scale （VAS）, sedation score, sulfentanil dosage, push times of PCA ,complication and patients＇ satisfaetory degree were recorded 1,4,24 and 48 h after PCIA. Results VAS in group P Ⅰ and group P Ⅱ was obviously lower than that in group C. The sextation score in groupP Ⅰ was significantly higher than that in group C. Sulfentanil dosage increased in the order of groupP Ⅰ ,group PⅡ and group C. Moreover,the number of PCA was lower in group P Ⅰ than in group P Ⅱ and group C. Compared with group C ,the incidence of abdominal distention and urine retention was lower in group P Ⅰ . Meanwhile more patients were satisfied with PCIA in group P Ⅰ than in group C. Conclusion Sulfentanil used as preemptive analgesia can relieve postoperative pain, reduce analgesic dosage and occurrence of complication.
出处
《中国医科大学学报》
CAS
CSCD
北大核心
2009年第2期145-147,150,共4页
Journal of China Medical University
关键词
舒芬太尼
超前镇痛
病人自控静脉镇痛
sulfentanil
preemptive analgesia
patient controlled intravenous analgesia
