摘要
目的探讨单用舒芬太尼和盐酸纳布啡联合舒芬太尼应用于妇产科开腹手术后患者自控静脉镇痛(PCIA)的临床效果及不良反应发生情况。方法 160例美国麻醉医师协会(ASA)Ⅰ~Ⅱ级的妇产科开腹手术患者,随机均分为观察组和对照组各80例,行PCIA。对照组:舒芬太尼2.8μg/kg+托烷司琼5 mg+生理盐水至100 ml。观察组:舒芬太尼100μg+盐酸纳布啡60~100 mg+托烷司琼5 mg+生理盐水至100 ml,两组持续量2 ml/h,单次给药量0.5 ml,锁定时间15 min,监测并记录术后4 h、8 h、12 h、24 h、48 h患者镇痛评分[采用视觉模拟评分法(VAS)],镇静分级评分(Ramsay评分)效果、不良反应发生情况。结果术后8 h、12 h、24 h、48 h患者镇痛VAS评分观察组均低于对照组,差异有统计学意义(均P<0.05),术后4 h、8h、12 h、24 h镇静Ramsayy评分观察组低于对照组,差异有统计学意义(均P<0.05),头晕、恶心、呕吐、瘙痒及呼吸抑制等不良发应发生率观察组显著低于对照组,差异有统计学意义(均P<0.05)。结论盐酸纳布啡与舒芬太尼联合用于PCIA时可产生协同作用,增强镇痛效果,减少不良反应的发生,且有利于加速患者康复。
Objective To explore the clinical effect and adverse reactions of nalbuphine hydrochloride dihydrate combined with sufentanil for patient controlled intravenous analgesia(PCIA） of patients after gynecological abdominal surgery. Methods A total of 160 patients of ASA Ⅰ-Ⅱ undergoing gynecological or obstetric laparotomy were selected and randomly divided into observation group and control group,80 patients in each group,PCIA was performed. The patients in control group were treated with sufentanil(2. 8 μg/kg）,tropisetron(5 mg）,and normal saline(total amount： 100 ml）; the patients in observation group were treated with sufentanil(100 μg）,nalbuphine hydrochloride dihydrate(60-100 mg）,tropisetron(5 mg）,and normal saline(total amount： 100 ml）. The continuous quantity in the two groups was 2 ml/h,the single dosage was 0. 5 ml,the locking time was 15 minutes. At 4,8,12,24,and 48 hours after surgery,VAS scores,Ramsay scores,and incidence rates of adverse reactions in the two groups were monitored and recorded. Results At 8,12,24,and 48 hours after surgery,VAS scores in observation group were statistically significantly lower than those in control group(P〈0. 05）. At4,8,12,and 24 hours after surgery,Ramsayy scores in observation group were statistically significantly lower than those in control group(P〈0. 05）. The incidence rates of adverse reactions(dizziness,nausea,vomiting,pruritus,respiratory depression） in observation group were statistically significantly lower than those in control group(P 〈 0. 05）. Conclusion Nalbuphine hydrochloride dihydrate and sufentanil can produce synergistic effect in PCIA,enhance analgesic effect,reduce the incidence rates of adverse reactions,and promote recovery of the patients.
作者
卢德强
高敏捷
LU De-Qiang;GAO Min-Jie(Department of Anesthesiology, the Third People＇s Hospital of Hainan Province, Sanya, Hainan 572000, Chin)
出处
《中国妇幼保健》
CAS
2018年第9期2128-2130,共3页
Maternal and Child Health Care of China
关键词
盐酸纳布啡
舒芬太尼
多模式镇痛
清醒镇痛
Nalbuphine hydrochloride dihydrate
Sufentanil
Multimodal analgesia
Conscious analgesia
