摘要
目的:观察地佐辛复合氟比洛芬酯用于肝功能不全剖宫产患者术后自控静脉镇痛(PCIA)的效果。方法:择期行剖宫产手术的肝功能不全患者120例,随机均分为3组,术后均采用自控镇痛泵镇痛。镇痛药配方分别为:A组:芬太尼0.5 mg+氟比洛芬酯250 mg;B组:地佐辛30 mg+氟比洛芬酯250 mg;C组:氟比洛芬酯250 mg。3组均加入昂丹司琼16 mg,且用生理盐水稀释至100 ml,初始负荷剂量2 ml,持续剂量2 ml/h,单次自控按压(PCA)剂量0.5 ml,时间15 min。观察并记录患者术后2、4、8、24、48 h的VAS疼痛评分以及术后24 h内PCA按压次数和不良反应。结果:术后各时点,C组VAS评分明显高于A组和B组(P<0.05),术后各时点A、B两组差异无统计学意义(P>0.05)。术后24h内C组PCA按压次数为(16.1±1.3)次,明显多于A组的(10.8±1.8)次和B组的(11.0±1.6)次(t=3.54、3.98,P<0.05)。3组患者均未出现呼吸抑制、异常出血等不良反应。A组患者眩晕、恶心和呕吐等不良反应总发生率(37.5%)明显高于B组(12.5%)和C组(10.0%)(P<0.05)。结论:地佐辛复合氟比洛芬酯可以安全有效地用于肝功能不全患者剖宫产术后镇痛。
Objective： To observe the effect of dezocine combined with flurbiprofen axetil in patient - controlled intravenous anal- gesia （PCIA） of patients with liver dysfunction after cesarean section. Methods： A total of 120 patients with liver dysfunction after elective cesarean section were selected and randomly divided into three groups, 40 patients in each group, all the patients in the three groups were treated with PCIA ; the drugs used in group A, group B, and group C were fentanyl 0. 5 mg ＋ flurbiprofen axetil 250 mg, dezocine 30 mg ＋ flurbiprofen axetil 250 mg, flurbiprofen axetil 250 rag; the patients in the three groups were treated with ondansetron 16 mg（ diluted to 100 ml with normal saline）, the initial load dosage was 2 ml, the continuous dose was 2 ml/h, the single dose of PCIA was 0. 5 ml, the treatment time was 15 minutes ; VAS scores, times of PCIA within 24 hours after treatment, and adverse reactions at 2, 4, 8, 24, 48 hours after treatment were observed and recorded. Results： VAS scores in group C at different time points after treatment were statistically significantly higher than those in group A and group B （ P 〈 0. 05 ）, but there was no statistically significant difference between group A and group B （ P 〉 0. 05 ） ; the times of PCIA within 24 hours after treatment in group C was （ 16. 1 ±1.3 ） times, which was statistically significantly higher than those in groupA [ （10.8±1.8） times~ and groupB [ （11.0±1.6） times] （t=3.54, P〈0.05; t=3.98, P〈0.05）; no adverse reactions occurred in the three groups, such as respiratory depression, abnormal bleeding; the total incidence rate of adverse reactions in group A was 37. 5%, which was statistically significantly higher than those in group B （ 12. 5% ） and group C （ 10. 0% ） （ P 〈 0. 05 ） . Conclusion： Dezocine combined with flurbiprofen axetil can be used for analgesia of patients with liver dysfunction after cesarean section safely and effectively.
出处
《中国妇幼保健》
CAS
北大核心
2013年第35期5892-5895,共4页
Maternal and Child Health Care of China
关键词
地佐辛
氟比洛芬酯
术后镇痛
肝功能不全
剖宫产手术
Dezocine
Flurbiprofen axetil
Postoperative analgesia
Liver dysfunction
Cesarean section
