皮下泵入芬太尼、利多卡因复合液用于非体外循环冠脉搭桥患者术后镇痛  

Analgesia effect of fentanyl lidocaine mixture by dermal pump on patients undergoing off-pump coronary arteria bypass graft surgery

作　　者：邹捍东[1] 吴灵潝[1] 曹经山[1] 李书闻[2] 

机构地区：[1]武汉大学人民医院麻醉科,430060 [2]北京市安贞医院麻醉科,100029

出　　处：《实用医学杂志》2004年第11期1230-1231,共2页The Journal of Practical Medicine

摘　　要：目的 :观察非体外循环冠脉搭桥 (OPCABG)患者术后芬太尼复合利多卡因皮下镇痛的效果。方法 :选取 5 0名OPCABG男性患者 ,年龄 40～ 80岁 ,体重 65～ 80kg ,随机分为两组 :D组 (n =3 0 )和V组 (n =2 0 ) ,D组患者术毕皮下接一次性止痛泵 ,配方为芬太尼 2mg +利多卡因 10 0mg加生理盐水至 2 0 0mL ;V组患者术毕接静脉止痛泵 ,配方为芬太尼 2mg加生理盐水至 2 0 0mL。泵流量为 2mL/h。记录患者术中咪唑安定、芬太尼用量 ,手术时间 ,苏醒时间 ,拔管时间 ,以及术后 4、8、12、16、2 4h的MAP、HR、SpO2 ,记录苏醒后 1、4、8、12、2 4hVAS评分和Ramsay镇静评分 ,总镇痛舒适评分 ,不良反应和要求追加止痛剂的情况。结果 :两组患者术后 4、8、12、16、2 4h的MAP、HR、SpO2 ,苏醒后 1、4、8、12、2 4h的VAS评分、Ramsay镇静评分 ,总镇痛舒适评分均差异无显著性 (P >0 0 5 )。两组患者要求追加止痛剂的比例相当 (P >0 0 5 ) ,仅有V组 1例患者出现轻度恶心反应。结论 :OPCABG患者术后皮下持续泵入芬太尼利多卡因复合液是一种方便可靠的术后镇痛技术。Objective To study the dermal analge si a effect of fentanyl mixed lidocaine on patients undergoing off-pump coronary a rteria bypass graft surgery (OPCABG). Methods Fifty OPCABG patients were randomly divided into two group: dermal group (n=30) (group D) and vein group (n=20) (group V). A fter operation, disposed 200 mL baxter analgesia pump were used to 0.1% fentany l+0.05% lidocaine (group D) and 0.1% fentanyl(group V) respectively, 2 mL/h co ntinuous injected. Anesthetic for operation, operation time, wake time, tube tim e, MAP, HR, SpO 2 of 4 h, 8 h, 12 h, 16 h and 24 h after operation were recor ded respectively, visual analogue scale (VAS), ramsay sedation scale(RSS) of 1 h , 4 h, 8 h, 12 h and 24 h after wake, analgesia comfort scale and complications were observed too. Results The difference of MAP, HR, SpO 2 of 4 h, 8 h, 12 h, 16 h and 24 h after operation between group D and group V were not significant (P>0.05), ant the difference of VAS, RSS of 1 h, 4 h, 8 h, 12 h and 24 h after wake, total analgesia comfort scale and complications between group D and group V were not significant (P>0.05). Conclusion Pumping fentanyl lidocaine mixture into dermal aft er OPCABG is a effective and advantageous analgesia technique.

关 键 词：皮下给药 芬太尼 利多卡因 体外循环 冠脉搭桥术 OPCABG 镇痛作用 

分 类 号：R614[医药卫生—麻醉学]