摘要
目的:探究骨科术后患者在自控静脉镇痛进行术后镇痛中舒芬太尼应用时机的不同对患者镇痛效果和不良反应的影响.方法:将2016年5月-2018年10月本院骨科术后进行自控静脉镇痛的患者76例随机分为2组,对照组在手术完成拔管后进行自控静脉镇痛,观察组在麻醉诱导前5分钟进行0.08μg/kg舒芬太尼的静脉注射且在手术完成前半小时进行自控静脉镇痛,比较2组术后不同时间在镇静评分、疼痛评分以及不良反应方面的差异.结果:术后1-4小时观察组患者的镇静评分显著高于对照组且疼痛评分较对照组更低(t=4.017、4.962,P=0.000、0.000),术后24-48小时,2组患者的相关评分无显著差异(t=0.272、0.313,P=0.786、0.755);在腹胀、恶心呕吐、尿潴留等不良反应的发生率方面,对照组、观察组患者分别为39.47%、18.42%,观察组较对照组更低(x^2=4.09,P=0.0430).结论:通过麻醉诱导前5分钟进行0.08μg/kg舒芬太尼的静脉注射且在手术完成前半小时进行自控静脉镇痛的超前镇痛方式,能够取得更加显著的镇痛效果,且患者出现的不良反应也会相应减少,临床应用效果较好.
Objective: To investigate the effect of sufentanil on the analgesic effect and adverse reactions of patients after orthopedic surgery in patient - controlled intravenous analgesia. Methods: 76 patients with PCEA after orthopedic surgery in our hospital from May 2016 to October 2018 were randomly divided into two groups. The control group received PCEA after extubation. The study group received 0. 08 ug/kg sufentanil intravenously 5 minutes before induction of anesthesia and the patient - controlled intravenous town half an hour before operation. The differences of sedation score, pain score and adverse reactions between the two groups at different time after operation were compared. Results: The sedation score of the study group was significantly higher than that of the control group 1 -4 hours after operation ,and the pain score was lower than that of the control group (t = 4. 017, 4. 962, P = 0. 000 , 0. 000). There was no significant difference between the two groups 24 -48 hours after operation (t = 0. 272, 0. 313, P = 0. 786, 0. 755 ). There were adverse reactions such as abdominal distension, nausea and vomiting, urinary retention, etc. In terms of incidence, the control group and the study group were 39.47% and 18.42%, respectively. The study group was lower than the control group (x^2 =4. 09, P =0. 0430). Conclusion: Preemptive intravenous injection of 0. 08 ug/kg sufentanil 5 minutes before anesthesia induction and patient - controlled intravenous analgesia half an hour before operation can achieve more significant analgesic effect, and the adverse reactions of patients will be reduced accordingly, and the clinical application effect is better.
作者
郭凤英
GUO Feng-ying(Department of anesthesiology, Nansha hospital, Guangzhou first peopled hospital, Guangzhou, Guangdong province,510000)
出处
《中国伤残医学》
2019年第15期17-18,共2页
Chinese Journal of Trauma and Disability Medicine
关键词
骨科手术
不同时机
舒芬太尼
自控静脉镇痛
镇痛效果
不良反应
Orthopaedic surgery
Different timing
Sufentanil
patient -controlled intravenous analgesia
Analgesic effect
Adverse reactions
