摘要
目的:对比可塞风加芬太尼、芬太尼加氟哌啶术后静脉自控镇痛术后24h、48h血中皮质醇浓度,同时观察其镇痛效果、镇痛药用量、不良反应等。方法:90例脊柱手术后病人,随机分为三组,每组30例,Ⅰ组芬太尼1mg加氟哌啶10mg,Ⅱ组可塞风16mg加芬太尼0.5mg,Ⅲ组可塞风24mg加芬太尼0.5mg,3组药液均配制为100ml,镇痛持续48-72h。结果:①血中皮质醇浓度(nmol/L):术后24h,Ⅰ组113.92±85.04;Ⅱ组56.06±28.77;Ⅲ组51.23±30.01,Ⅱ、Ⅲ组与Ⅰ组比较P<0.01,48小时各组间比较无差异P>0.01。②镇痛优良率(VAS<3分):Ⅱ组(90％)、Ⅲ组(93.3％)与Ⅰ组(60％)比较P<0.01。③芬太尼用量(ug/h):Ⅱ组7.75±1.52、Ⅲ组6.92±1.73、Ⅰ组18.24±7.44,Ⅱ、Ⅲ组与Ⅰ组比较P<0.01。④不良反应:恶心呕吐:Ⅰ、Ⅱ组无病例,Ⅲ组1例;头晕:Ⅰ组5例,Ⅱ、Ⅲ组无病例;腹涨:Ⅰ组1例,Ⅱ、Ⅲ组无病例。结论:可塞风在治疗剂量范围内(<16mg/24h)复合芬太尼用于PCIA可显著减少芬太尼用量,减轻病人术后应激反应,同时降低阿片类镇痛药的副作用。
Objective: To compare the postoperative patients's blood cortisol levels at 24h and 48h after PCIA using xafon and fentanyl with the levels after PCIA using fentanyl and droperidol. At the same time to observe the analgesia effects, the analgesic doses, and the side effects. Methods: 90 spinal postoperative patients were divided into three groups equally and were treated with different medicines. Group Ⅰ : fentanyl Img and droperidol 10mg; Group Ⅱ : xafon 16mg and fentanyl 0. 5mg; Group Ⅲ : xafon 24mg and fentanyl 0. 5mg. All the medicines of the three groups were dissolved into 100 ml solutions and the analgesia processes last 48-72h. Results: ① Blood cortisol level(nmol/L) : Group Ⅰ 113. 92 ± 85. 04, Group Ⅱ 56. 06 ± 28. 77 and Group Ⅲ51. 23 ± 30. 01 at 24h. The cortisol level of Group Ⅱ and Group Ⅲ were lower compare to Group Ⅰ (P<0. 01) at 24h and there were no differences among these three groups at 48h(P>0. 01). ② Sedation scores( VAS<3) : The scores of Group I (60%) were obvious lower than GroupⅡ (90%)and Group Ⅲ (93. 3%)(P<0. 01). ③ Fentanyl dose(ug/h) ; GroupⅡ 7. 75 ± 1. 52, Group Ⅲ 6. 92 ± 1. 73, Group Ⅰ 18. 24 ± 7. 44, the dose of Group I was significant higher (P<0. 01). ④ Side effects: Nausea: Group Ⅰand GroupⅡ have no case, Group Ⅲ has 1 case. Dizzy: Group Ⅰ has 5 cases, Group Ⅱ and Group Ⅲ have no case. Abdominal distention: Group Ⅰ has 1 cases, Group Ⅱ and Group Ⅲ have no case. Conclusion: The combine treatment of Xafon at the range of therapy allowing dose (<16mg/24h)and fentanyl in PCIA could significantly reduce the fentanyl dose, relieve the stress of postoperative patients, and at the same time decrease the side effects of opium kind analgesics.
出处
《中国临床医学》
2004年第2期238-240,共3页
Chinese Journal of Clinical Medicine
