右旋酮洛酚用于人工髋关节置换术围术期对术后镇痛吗啡用量的影响  

Effect of perioperative administration of dexketoprofen on the dose of morphine in patient-controlled analgesia after artificial hip jiont replacement

作　　者：张恒文[1] 王衍敏[2] 

机构地区：[1]中国医科大学附属第一医院麻醉科,辽宁沈阳110001 [2]鞍钢铁西医院麻醉科

出　　处：《中国医科大学学报》2005年第6期585-587,共3页Journal of China Medical University

摘　　要：目的:通过对吗啡的术后镇痛使用量和副作用的比较,评价右旋酮洛酚在围术期的有效性和镇痛效果.方法:选择50例ASA I～Ⅱ级人工髋关节置换术的病人,随机分为右旋酮洛酚组(D组)和安慰剂组(P组).应用脊椎-硬膜外联合麻醉,蛛网膜下腔注入0.5%重比重布比卡因和吗啡0.6 mg,硬膜外腔置管后用2%利多卡因维持,吗啡病人自控镇痛法术后镇痛.结果:D组术后疼痛程度比P组减轻(P＜0.05),D组吗啡的用量比P组明显减少(P＜0.01或0.05).D组术后18 h内发生恶心、呕吐明显比P组少(P＜0.01),D组术后15 h内镇静效果比P组好(P＜0.01).结论:人工髋关节置换术病人于术前1 d和术后2 d口服右旋酮洛酚可以明显增强吗啡的镇痛作用,减少吗啡的用量和减少相关的副作用.Objective： To evaluate the effectiveness and analgesic efficacy of dexketoprofen administered perioperatively by comparing the dose and adverse effect of morphine in postoperative patientcontrolled anesthesia. Methods： Fifty ASA Ⅰ or Ⅱ patients undergoing artificial lfip joint replacement were randomly divided into 2 groups ： group D, receiving dexketoprofen of 25 mg both 24 hours before and 48 hours after the surgery, and group P, receiving placebo. Combined spinal-epidural anaesthesia was used. Hyperbaric bupivacaine of 0.5% and morphine of 0.6 mg were administered intrathecally. Lidocaine of 2% was used for epidural block, and morhpine was used in postoperative patient-controlled anesthesia. Resutls ： After the surgery , patients in group D experienced less degree of pain compared with patients in group P （ P 〈 0.01 ）. The dose of morphine in group D was much less than that in group P （ P 〈 0.01 ）. The incidenc of nausea and vomitting 18 hours after the surgery in group D was lower than that in group P （ P 〈0.01 ）. The sedative effect 15 hours after surgery in group D was better than that in group P （ P 〈 0.01 ）, Conclusion： Dexketoprofen administered 1 day before and 2 days after the artificial hip joint replacement may markedly enhance the analgesic effect of morphine and decrease the dose and the incidence of related adverse effect of morphine.

关 键 词：右旋酮洛酚 人工髋关节置换术 围术期 

分 类 号：R614.4[医药卫生—麻醉学]