摘要
目的比较瑞芬太尼、吗啡、芬太尼用于老年患者术后自控静脉镇痛(PCIA)的效果。方法ASAⅡ～Ⅲ级择期老年手术患者90例,随机分成瑞芬太尼组、吗啡组和芬太尼组各30例,分别用瑞芬太尼0.02 mg.kg-1,吗啡1.5 mg.kg-1,芬太尼0.02 mg.kg-1,加生理盐水至100 ml行术后PCIA,设定持续给药量为2 ml.h-1,PCIA为每次0.5 ml,锁定时间15 min。观察术后2 h、4 h、8 h、12 h、24 h、48 h各时间段内的视觉模拟评分、恶心、呕吐、皮肤瘙痒及患者按压次数与有效按压次数之比(T/E)。结果在术后2 h、4 h、8 h、12 h时间段内瑞芬太尼、吗啡组镇痛效果优于芬太尼组(P<0.05);瑞芬太尼组T/E比在2 h、4 h、8 h、12 h时间段内明显高于其他2组(P<0.05);吗啡组恶心、呕吐在3分级别明显高于其他2组(P<0.05),芬太尼组皮肤瘙痒发生率明显高于其他2组(P<0.05)。结论瑞芬太尼用于老年患者术后静脉镇痛效果满意,副作用少,可安全用于老年患者术后镇痛。
Objective To compare the patient controlled intravenous analgesia （PCIA） effect of remifentanil, morphine and fentanly for senile patients post operation. Methods Ninety senile patients with ASA Ⅱ～Ⅲ who were performed with elective operations, were ＂divided into three groups randomly. Remifentanil group, morphine group and fentanly group, each group with 30 cases. Remifentanil group with remifentanil 0.02 mg · kg^-1 , morphine group with morphine 1.5 mg·kg^-1, fentanly group with fentanly 0.02 mg·kg^-1. Each group was diluted with 0.9% saline solution to total 100 ml. PCIA was done with the injection, continuous infusion dosage was set up to 2 ml·h^-1 ,the dosage was set up to 0.5 ml every time,and the interval was set up to 15 min. Visual simulation score,nausea,emesia and itch of skin were observed post operation 2 h,4 h,8 h,12 h,24 h, 48 h and total patient controlled analgesia/effective patient controlled analgesia （TPCA/EPCA） were observed also. Results The effect of analgesia in remifentanil group and morphine group had an advantage to fentanly group（P 〈0. 05） post operation 2 h,4 h,8 h and 12 h. TPCA/EPCA in remifentanil group was higher than that in morphine group and fentanly group（P 〈0.05）. Nausea and emesia in morphine group with three grade was higher than that in remifentanil group and fentanly group （P 〈 0. 05 ）. The incidence rate of itch of skin in fentanyl was higher than that in remifentanil group and morphine group. Conclusion Remifentanil was effective and safe in PCIA for senile patient post operation with few side effects.
出处
《新乡医学院学报》
CAS
2007年第4期380-382,共3页
Journal of Xinxiang Medical University
关键词
瑞芬太尼
芬太尼
吗啡
静脉自控镇痛
remifentamil
morphine
fentanly
patient controlled intravenous analgesia
