摘要
目的观察不同剂量苏芬太尼复合小剂量氯胺酮在术后静脉自控镇痛中的效果，寻找苏芬太尼较为理想的配伍剂量。方法年龄30～60岁，ASAI-Ⅱ级，在静吸复合全麻下择期行子宫全切术的患者90例，随机分为三组（n=30），A组苏芬太尼1．5μg／kg、B组苏芬太尼2．0μg／kg、C组苏芬太尼2．5μg／kg，所有镇痛泵均加入氯胺酮4mg／kg和止吐药托烷司琼4mg并用0．9％氯化钠注射液稀释至100ml。记录术后4h、12h、24h、48h视觉模拟评分（VAS）、镇静评分（SS）及不良反应。结果A组VAS评分显著高于B、C组（P〈0．05），而C组SS评分显著高于A、B组（P〈0．05）；C组恶心呕吐发生率高于A、B组（P〈0．05），余不良反应三组间差异无统计学意义（P〉0．05）。结论B组配伍在妇科术后静脉自控镇痛具有较好效果，不良反应少。
Objective To observe the effect of gynecologic surgery patient-controlled intravenous analgesia （PCIA） with different-dose sufentanil combined with ketamine for obtaining a better medicine compatibility. Methods Ninety patients, ASA I -II,30- 50 years old, scheduled for hysterectomy under general anesthesia, were randomly divided into three groups：A,B and C;30 adults were included in each group. （sufentanil 1.5μg · kg^-1 ＋ ketamine 4mg ·kg^-1 ）/100ml, （ sufentanil 2.0μg ·kg^-1 ＋ ketamine 4mg · kg^-1 ）/100ml, （ sufentanil 2.5μg · kg^-1 ＋ ket- amine 4mg · kg^-1 ）/100ml, was used in A, B, C group respectively. Tropisetron 4mg was added in every patient. VAS, sedative scores, respiratory depression, nausea and vomiting, delire, dizzy and pruritus were recorded at the time points of 4,12,24 and 48h after operation. Results VAS scores in group A was significantly higher than those in group B and group C at all three time points（P 〈0. 05） ,while SS in group C was significantly higher than those in group A and group B at all three time points（P 〈0. 05）. Nausea and vomiting in group C was significantly more than that in group A and B （P 〈 0. 05 ）, and there were no significant difference in the other side effects among three groups. Conclusion Patient-controlled intravenous analgesia（PCIA） with sufentanil 2.0μg · kg^-1 ＋ ketamine 4mg · kg^-1 ）/ 100ml is a better medicine compatibility in gynecological postoperative patients, it can provide better post-operative analgesia, also can lower adverse effect.
出处
《中国基层医药》
CAS
2010年第7期904-905,共2页
Chinese Journal of Primary Medicine and Pharmacy
关键词
镇痛
病人控制
静脉
苏芬太尼
氯胺酮
Analgesia, patient controlled
Intravenous
Sufentanil
Ketamine
