摘要
目的 探讨羟考酮与舒芬太尼用于剖宫产术后静脉自控镇痛的效果。方法 选取2016年2—10月于首都医科大学附属北京佑安医院择期行剖宫产术的足月单胎初产妇110例，采用随机数字表法将其随机分为舒芬太尼组和羟考酮组，各55例。产妇均在在蛛网膜下腔麻醉下行剖宫产术，术毕接静脉自控镇痛泵，舒芬太尼组药物为舒芬太尼150 μg＋0.9%氯化钠注射液稀释至100 ml，羟考酮组药物为盐酸羟考酮注射液50 mg＋0.9%氯化钠注射液稀释至100 ml。静脉自控镇痛设置为持续输注速度2 ml/h，单次追加0.5 ml，锁定时间15 min。术后2、4、6、8、12、24 h采用疼痛视觉模拟量表（VAS）评估产妇的切口痛及宫缩痛镇痛效果。记录产妇对术后镇痛的满意度。观察不良反应的发生情况。结果 羟考酮组术后8、12、24 h切口痛VAS评分明显低于舒芬太尼组，差异有统计学意义［（3.0±1.3）分比（3.7±1.5）分、（2.4±1.0）分比（3.2±1.5）分、（1.4±1.1）分比（2.6±1.7）分］（P＜0.05或P＜0.01）。羟考酮组术后2、4、6、8、24 h宫缩痛VAS评分明显低于舒芬太尼组，差异有统计学意义［（2.2±0.6）分比（3.2±1.0）分、（5.2±2.8）分比（6.8±1.7）分、（5.2±1.6）分比（6.7±1.8）分、（4.4±1.6）分比（5.6±2.1）分、（1.6±1.5）分比（3.2±2.4）分］（P＜0.05或P＜0.01）。羟考酮组的术后镇痛满意度明显优于舒芬太尼组（P＜0.01或P＜0.05）。2组不良反应发生率差异无统计学意义（P＞0.05）。结论 在剖宫产术后镇痛中，羟考酮的镇痛效果优于舒芬太尼。
Objective To investigate the effect of patient-controlled intravenous analgesia（PCIA） with oxycodone and sulfentanyl on postoperative pain in patients after cesarean section. Methods Totally 110 primiparous women with term pregnancy who had cesarean section under subarachnoid anesthesia in Beijing YouAn Hospital, Capital Medical University from February to October 2016 were enrolled. The patients were randomly allocated to have PCIA with sulfentanyl（sulfentanyl group, 55 cases, sulfentanyl 150 μg＋0.9% sodium chloride injection, 100 ml） and oxycodone（oxycodone group, 55 cases, oxycodone hydrochloride injection 50 mg＋0.9% sodium chloride injection, 100 ml）; PCIA was set as 2 ml/h continuous infusion and single additional dose of 0.5 ml with 15 min intervals. Visual Analogue Scale（VAS） was used to evaluate incision pain and uterine contraction pain 2, 4, 6, 8, 12, 24 h after operation. Satisfaction degree of postoperative analgesia was recorded. Adverse reactions were observed. Results VAS scores of analgesia pain 8, 12, 24 h after operation in oxycodone group were significantly lower than those in sulfentanyl group[（3.0±1.3）scores vs （3.7±1.5）scores, （2.4±1.0）scores vs （3.2±1.5）scores,（1.4±1.1）scores vs （2.6±1.7）scores]（P〈0.05 or P〈0.01）. VAS scores of uterine contraction pain 2, 4, 6, 8, 24 h after operation in oxycodone group were significantly lower than those in sulfentanyl group[（2.2±0.6）scores vs （3.2±1.0）scores, （5.2±2.8）scores vs （6.8±1.7）scores, （5.2±1.6）scores vs （6.7±1.8）scores, （4.4±1.6）scores vs （5.6±2.1）scores, （1.6±1.5）scores vs （3.2±2.4）scores]（P〈0.05 or P〈0.01）. Satisfaction degree of postoperative analgesia in oxycodone group was significantly higher than that in sulfentanyl group（P〈0.01 or P〈0.05）. Incidence of adverse reactions had no significant differences between groups（P〉0.05）. Conclusion Oxycodone has a better analgesia effect than sulfentanyl on patients after
作者
贺海丽
权哲峰
池萍
刘晓鹏
He Haili Quan Zhefeng Chi Ping Liu Xiaopeng(Department of Anesthesiology, Beijing YouAn Hospital, Capital Medical University, Beijing 100069, China)
出处
《中国医药》
2017年第7期1057-1060,共4页
China Medicine
关键词
剖宫产术
经静脉患者自控镇痛
羟考酮
舒芬太尼
Cesarean section
Patient-controlled intravenous analgesia
Oxycodone
Sulfentanyl
