摘要
目的本研究拟评价曲马多联合舒芬太尼或氟比洛芬酯用于经腹全子宫切除术后病人自控静脉镇痛(patient-controlled intravenous analgesia,PCIA)的效果。方法拟择期经腹子宫全切病人150例,根据不同PCIA方案,采用随机数字表法分为3组:曲马多组(n=50),曲马多0.3 mg/(kg·h);曲马多+氟比洛芬酯组(n=50),曲马多0.2mg/(kg·h)+氟比洛芬酯100 mg和曲马多+舒芬太尼组(n=50),曲马多0.2 mg/(kg·h)+舒芬太尼0.02μg/(kg·h)。术毕前30 min,静脉注射曲马多2 mg/kg,术毕行PCIA。记录术后2、6、12、24 h和48 h Ramsay评分、药物消耗量、有效按压次数、芬太尼追加量及不良反应。结果与曲马多组及曲马多+氟比洛芬酯组比较,曲马多+舒芬太尼组术后2、6、12、24 h Ramsay评分明显升高(P<0.05或0.01),术后2 h药物消耗量、各时间点有效按压次数、芬太尼追加量及恶心呕吐发生率明显降低(P<0.05或0.01);与曲马多组比较,曲马多+氟比洛芬酯组术后2 h和24 h Ramsay评分明显升高(P<0.05或0.01),术后2 h有效按压次数及芬太尼追加量明显降低(P<0.01),恶心呕吐发生率无统计学差异(P>0.05)。结论曲马多0.2 mg/(kg·h)+舒芬太尼0.02μg/(kg·h)方案用于妇科经腹全子宫切除术后PCIA效果优于联合氟比洛芬酯或单一用药方案。
Objective To evaluate the efficacies of tramadol combined with sulfentanil or flurbiprofen for postoperative patient-controlled intravenous analgesia（PCIA）after laparohysterectomy.Methods One hundred and fifty patients scheduled for laparohysterectomy were randomly divided into tramadol group（n=50）：tramadol 0.3 mg/（kg·h）,tramadol＋flurbiprofen group（n=50）：tramadol 0.2 mg/（kg·h）＋flurbiprofen 100 mg and tramadol＋ sulfentanil group（n=50）：tramadol 0.2 mg/（kg·h）＋sulfentanil 0.02μg/（kg·h）,all patients were diluted to 100 ml for PCIA.Ramsay scores,PCIA analgesic consumption,effective bolus,fentanyl compensative consumption and adverse reactions were recorded at 2,6,12,24 and 48 hours after surgery.Results Compared with tramadol group and tramadol＋flurbiprofen group,tramadol＋ sulfentanil group showed Ramsay scores significantly increased at 2,6,12 h and 24 h after surgery（P〈0.05 or 0.01）with decreased analgesic consumption at 2 h after surgery（P〈0.05）,effective bolus（P〈0.05）,fentanyl consumption（P〈0.05）and incidence of nausea and vomiting（P〈0.05）.Compared with tramadol group,tramadol＋flurbiprofen group also showed Ramsay scores significantly increased at 2 h and 24 h after surgery（P〈0.05）,effective bolus decreased at 2 h after surgery（P〈0.05）and fentanyl consumption decreased（P〈0.05）.Conclusion Tramadol combination regimens have superiority to tramadol monotherapy for PCIA after gynecological laparohysterectomy,and tramadol combined with sulfentanil provides better efficacy than tramadol combined with flurbiprofen regimen.
出处
《华南国防医学杂志》
CAS
2017年第9期597-600,共4页
Military Medical Journal of South China
