盐酸瑞芬太尼用于腹式子宫切除术后病人自控镇痛的研究  

Comparison of patient-controlled analgesia with remifentanil versus morphine after abdominal hysterectomy

作　　者：赵大忠[1] 黄绍农[1] 陈建颜[1] 卢建芳[1] 赵迅[1] 

机构地区：[1]深圳市第二人民医院麻醉科,518035

出　　处：《中国妇幼保健》2005年第2期223-225,共3页Maternal and Child Health Care of China

摘　　要：目的评价盐酸瑞芬太尼用于妇科病人术后自控镇痛(PCA)的效应和安全性。方法60例妇科开腹子宫切除病人,术后随机分为盐酸瑞芬太尼组(R组,n=30)和吗啡组(M组,n=30)接受PCA治疗。R组使用盐酸瑞芬太尼(20ug/次,1mg/24h),M组使用吗啡(1mg/次,30mg/24h)。结果盐酸瑞芬太尼与吗啡组24h总疼痛程度差值(SPID)分别为300(92)和213(87)(P<005)。R组恶心(2667%和3667%,P<005)及呕吐(1667%和2333%,P<005)等的发生率均低于M组。结论盐酸瑞芬太尼用于妇科手术后PCA的镇痛效应强于吗啡,副作用弱于吗啡。Objective:To compare the analgesic efficacy and safety of patient-controlled analgesia (PCA) with remifentanil and PCA with morphine after abdominal hysterectomy. Methods:sixty patients aged 40～59 years old undergoing abdominal hysterectomy were included in this study. Patients with severe cardiac, cerebral, hepatic and renal disease and those who had recently taken monoamine oxidase inhibitor were excluded. The patients were randomly divided into remifentanil group (R,n=30) and morphine group (M, n=30). Patients in group R received PCA with remifentanil and in group M received PCA with morphine. Intensity of pain was assessed using VAS with 0 representing no pain and 10 representing the worst pain, Pain intensity difference before and after PCA and pain relied (PAR) (0=not relieved, 4=completely relieved), patient satisfaction and adverse effects were recorded .Results:The two groups were comparable with regard to age, body weight, duration of operation, the time when postoperative pain started and PCA was commenced, and the intensity of postoperative pain. There was significant difference in pain intensity before and after PCA and PAR between the two groups. The incidence of nausea and vomiting was significantly higher in group M than those in group R (P<0.0.5). Conclusion:The analgesic efficacy of PCA with remifentanil is stronger than that of PCA with morphine but the incidence of nausea and vomiting is wealcer in PCA with remifentanil.

关 键 词：盐酸瑞芬太尼 镇痛 子宫切除术 

分 类 号：R714.3[医药卫生—妇产科学]