可塞风用于剖宫产术后病人静脉自控镇痛的临床观察  

Clinical observation on the effects of xafon on patient-controlled Intravenous analgesia after cesarean delivery

作　　者：唐万碧[1] 张光新[1] 金菊英[1] 闵苏[1] 

机构地区：[1]重庆医科大学附属第一医院麻醉科,重庆400016

出　　处：《重庆医科大学学报》2006年第5期728-730,共3页Journal of Chongqing Medical University

摘　　要：目的:观察可塞风用于剖宫产术后PCIA治疗对产妇和新生儿的影响。方法:60例ASAⅠ￣Ⅱ级、单胎、足月妊娠行剖宫产的产妇,年龄22￣34岁,随机分为两组,每组各30例,均在持续性硬膜外阻滞下完成经腹子宫下段剖宫产手术,术毕开始PCIA治疗。其药液配方为:Ⅰ组曲马多400mg,芬太尼0.4mg,氟哌利多2.5mg。Ⅱ组曲马多400mg,可塞风32mg,氟哌利多2.5mg。两组产妇药液中均加入生理盐水至总量为60ml的复合液。观察产妇术后4、8、12、24、48h的BP、HR、RR、SpO2、镇静、恶心、呕吐、眩晕、出汗、瘙痒、异常出血、手术切口和子宫收缩痛的镇痛效果及药物用量。新生儿Apgar评分,新生儿出生后12、24、48、72h母乳喂养率、皮肤和口唇颜色、睡眠和体动、喷奶等。结果:两组产妇生命体征平稳,SpO2均95%以上,手术切口和子宫收缩镇痛效果满意(P>0.05),不良反应发生率Ⅱ组比Ⅰ组更低(P>0.05)。两组新生儿接受母乳喂养率无明显差异(P>0.05),皮肤和口唇颜色、睡眠和体动反应均无异常(P>0.05),无明显喷奶。结论:可塞风用于剖宫产术后PCIA治疗能迅速有效缓解手术切口和子宫收缩疼痛,不良反应很少,对母乳喂养后的新生儿无不良影响,可安全用于产妇术后镇痛治疗。Objectives： To determine the effects of Patient-Controlled Intravenous Analgesia （PCIA） on parturien and neonatal by using xafon after Cesarean Section. Methods： 60 parturients in auordance with American Society of Anesthesiologists （ASA） physical status I or Ⅱ, aging from 22-34 year and undergoing cesarean section with epidural anesthesia were enrolled in this study. Postoperatively, patients were randomly divided into two groups with 30 cases each： group I PCIA with 0.4mg of fentanyl, 400mg of tramadol and 2.5rag of droperidol attenuated to 60ml with 0.9%N. S 47ml; group Ⅱ PCIA with 32mg of xafon, 400mg of tramadol and 2.5mg of droperidol attenuated to 60ml with 0.9%N.S 45ml. Heart rate （HR）, blood pressure （BP）, respiration （RR）, pulse oxygen saturation （Sp02）, sedation score （SS）, visual analogue scales（VAS）, analgesics consumption of the patients as well as side effects such as lethargy, nausea, vomiting, vertigo sweating, pruritus and abnormal bleeding were observed at 4, 8, 12, 24, and 48 hours after operation. Neonatal characteristics including breast feeding, Apgar scores, color of skin and lip, sleeping, movement response and regurgitation were recorded at 12, 24, 48 and 72 hours after dehvery. Results： The vital signs of all parturients in each group were stable. Both solutions could provide satisfactory analgesia effects （ P 〉 0.05 ）. The side effects occurrence rate of group Ⅱ was lower then that of group I （ P 〉 0.05 ） .Breast feeding of the neonates as well as color of skin and lip, sleeping, movement response and regurgitation had no significant difference in both groups. Conclusions： PCIA using xafon after cesarean delivery can provide excellent analgesic effect but few side effects At the same time, it has no adverse effect on neonates. Xafon may be safely administered intravenously with other narcotics in parturients undergoing cesarean section.

关 键 词：可塞风 剖宫产术 产妇 新生儿 病人静脉自控镇痛(PCIA) 

分 类 号：R614.24[医药卫生—麻醉学]