摘要
【目的】观察氢吗啡酮超前镇痛对骨科手术术后舒芬太尼用量的影响、安全性和不良反应。【方法】选择60例择期全麻骨科手术分为两组,每组30例,对照组诱导前10 min静脉滴注生理盐水1.0 ml,观察组诱导前10 min静脉滴注氢吗啡酮0.015 mg/kg。接镇痛泵,均采用舒芬太尼,进行术后患者静脉自控镇痛术(patient-controlled intravenous analgesia,PCIA)观察术后2、6、12、24、48 h的ECG、SPO2、RR、BP疼痛及镇静评分并记录恶心、呕吐、瘙痒等不良反应,观察记录两组术后48 h内镇痛按压次数及舒芬太尼总用量。【结果】术后2、6、12 h疼痛评分(visual anaglogue scale,VAS)观察组明显低于对照组(P<0.05),镇静评分(sedation scale,SS)术后各时点比较差异无统计学意义(P>0.05),术后48 h镇痛按压次数对照组多于观察组,差异有统计学意义(P<0.05),术后两组患者48 h舒芬太尼总量对照组多于观察组,差异有统计学意义(P<0.05),观察组术后镇痛不良反应少于对照组(P<0.05)。诱导开始前至手术结束,超前镇痛(观察组)的心率与平均动脉压均低于对照组,且在插管后5 min至手术结束时明显低于对照组(P<0.05)。【结论】氢吗啡酮超前镇痛,不仅能达到满意的术后镇痛效果,而且能减少舒芬太尼术后镇痛的用量,减少不良反应。不会引发患者心血管反应的增多。
【Objective】To observe the preemptive-analgesia effects of hydromorphone on the usage, safety and adverse reactions of sufentanil after the orthopedic surgery.【Methods】A total of 60 cases undergoing selective orthopedic surgery via general anesthesia were divided into two groups, 30 cases per group. Patients in the control group received 1.0 ml of saline via injection drip at 10 min before the induction, while patients in the observation group received hydromorphone in a dose of 0.015 mg/kg at 10 min before the induction. Then sufentanil（patient-controlled intravenous analgesia, PCIA） was used as an analgesia pump. The postoperative ECG, SPO2, RR, BP and scores of pain and sedation were observed at 2, 6, 12, 24 h and 48 h after the operation. The adverse effects such as nausea, vomit and itch were recorded. The times of analgesia pressing and total dosage of sufentanil in both groups were recorded within 48 h after the operation.【Results】At 2, 6 and 12 h after the operation, visual analogue scale（VAS） in the observation group was significantly lower than that in the control group（P0.05）. However, sedation scale（SS） showed no statistical difference at all time-points（P 0.05）. Times of analgesic pressing in the control group were more than those in the observation group within 48 h after the operation（P 0.05）. The total dosage of sufentanil in the control group was more than that in the observation group within 48 h after the operation（P 0.05）. The postoperative analgesic adverse reactions in the observation group were less than those in the control group（P0.05）. The heart rate（HR） and mean arterial pressure（MAP） in the observation group were lower than those in the control group from the beginning of anesthesia induction to the end of operation, and the indexes were significantly lower than those in the control group from 5 min after the endotracheal intubation to the end of operation（P0.05）.【Conclusion】The preemptive analgesia of hydromorphone not only ac
作者
刘森
秦树国
LIU Sen QIN Shu-guo(Department of Anesthesiology, Inner Mongolia Autonomous Region Corps Hospital of PAP, Hohhot 010040, China)
出处
《武警后勤学院学报（医学版）》
CAS
2016年第8期637-639,643,共4页
Journal of Logistics University of PAP（Medical Sciences）
关键词
氢吗啡酮
超前镇痛
舒芬太尼
Hydromorphone
Preemptive analgesia
Sufentanil
