氢溴酸高乌甲素复合舒芬太尼术后静脉镇痛的临床应用
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【摘要】 目的 研究氢溴酸高乌甲素复合舒芬太尼术后静脉镇痛的临床效果。方法 60例ASA1—2级全麻股骨手术患者，随机分为两组。A组舒芬太尼150ug加长托宁0.3mg B组 舒芬太尼100ug加氢溴酸高乌甲素16mg和长托宁0.3mg,两组均以生理盐水稀释至100ml按2.0ml/h速度使用一次性微量连续输注静脉持续镇痛48小时。比较两者镇痛效果，以及恶心，呕吐，皮肤骚痒，尿潴留，嗜睡，呼吸抑制等并发症的发生率。 结果 两组患者术后48小时镇痛效果均满意，视觉模拟评分(VAS)差异无显著性，但B组术后恶心，呕吐，皮肤骚痒，尿潴留，嗜睡发生率明显低于A组(P<0.01)。结论 氢溴酸高乌甲素复合舒芬太尼术后静脉镇痛是安全有效的，可以减少芬太尼的用量及不良反应。
【关键词】 氢溴酸高乌甲素 舒芬太尼 术后静脉镇痛
Clinical application of lappaconite hydrobromide combined with sufentanil for postoperative analgesia
Li Xinchun
Department of anesthesiologythe second Hospital of ShangLiu County 610213
【Abstract】objectiveTo evaluate the clinical efficacy of lappaconial hydrobromide combined with sufentanil for postoperative in travenous analgesia .Methods sixty ASA 1-2patiients underwent spinal surgery were dedived into two groups with 30cases each .Lappaconite hydrobromide 16mg pius sufentanil 100ug was used in group B and sufentanil 150ug alone in group Aas a control .Penehyclidine hydrochloride 0.3mg wasadded into the analgesic solution that wasdiluted to 100ml with normal saline in both groups .Analgesic solution was diluted continuously in a dose of 2ml /h for 48h postoporatively and analgesia was evaluated by VAS and sid effects were rcorded .ResultsPostoperative analgesia was satisfactory in both groups ,but the side effects includingnausea ,vomiting ,skin pruritus and lethargy were significantly less in group B than those in group A (P<0.01).Conclusion Lappaconite hydrobromide combined with sufentanil is effective and safe for postpenrative intravenous analgesia with the advantages of redusing sufentanil requirement and its side effects .
【Key Words】 Lappaconite hydrobromide;Sufentanin;Postoperative analgesia
【中图分类号】 R971+.2【文献标识码】 B【文章编号】 1007-8231(2011) 08-0725-02
随着术后静脉舒芬太尼镇痛的广泛应用,患者对术后镇痛的效果基本满意,但由于大剂量的舒芬太尼静脉镇痛引起的恶心,呕吐,皮肤骚痒,尿潴留,嗜睡等不良反应的发生率较高,临床应用受到限制。本研究将舒芬太尼与氢溴酸高乌甲素合用并与单用舒芬太尼进行比较,观察两组镇痛效果与不良反应的发生率。
1资料与方法
1.1一般资料随机选择择期股骨手术患者60例,女20例 男40例ASA1_2级,年龄25-65岁,体重50-75Kg,采用随机双盲法,将患者分成两组,舒芬太尼组(A组=30)和氢溴酸高乌甲素复合舒芬太尼组(B组=30),术前检查患者无严重呼吸循环系统疾病及严重肝肾疾病。
1.2麻醉方法全部采用静脉吸入复合全身麻醉。术前用药苯巴比妥钠0.1mg,阿托品0.5mg,麻醉检测,迈瑞9000检测仪持续检测HR BP SPO2。麻醉诱导,芬太尼4-5mg/kg,丙泊酚1.5-2.0mg/kg,琥珀胆碱1-105mg/kg,气管插管接麻醉机行间歇正压通气,调节潮气量VT8-10ml/kg,RR12-14次/分I:E为1:2,麻醉维持吸入1-1.5异氟醚,间断给,芬太尼,顺苯阿曲库铵。术毕A组舒芬太尼150ug长托宁0.3mg。B组舒芬太尼100ug+高乌甲素16mg+长托宁0.3mg。两组均以生理盐水稀释至100ml。按2.0ml/h速度静脉输注持续镇痛48小时。
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