颌面外科术后不同镇痛药自控镇痛效果观察  

Patient Controlled Analgesia with Different Analgetics in Oral and Maxillofacial Surgery

作　　者：卢玲玲 马加海 李源 

机构地区：[1]第四军医大学口腔医院麻醉科,陕西西安710032

出　　处：《口腔颌面外科杂志》2006年第4期356-358,共3页Journal of Oral and Maxillofacial Surgery

摘　　要：目的:观察不同配方镇痛药用于颌面外科手术后病人自控静脉镇痛(patient controlled intravenous analgesia,PCIA)的效果。方法:颌面外科全麻手术患者共296例,术后接受PCIA治疗,按术后镇痛药配方不同分成8组,分别是:芬太尼组(F)、芬太尼-氟哌利多组(FD)、芬太尼-昂丹司琼组(FO)、舒芬太尼组(SF)、舒芬太尼-昂丹司琼组(SFO)、丁丙诺非组(B)、丁丙诺非-昂丹司琼组(BO)和氯诺昔康组(L)。所用药物均加生理盐水至100 mL,按2 mL/h,单次剂量0.5 mL,锁定时间15 min。分别进行视觉模拟评分(visual analogue scale,VAS)、患者满意度和不良反应的比较。结果:SFO和L组的VAS各是1.3±0.7和1.3±0.6,与F组和FD组比较差异显著(P<0.05);SFO、SF和L组的患者满意率高于FD组;各组间不良反应发生率无明显差异,恶心呕吐发生率以口内手术病例为高。结论:芬太尼、舒芬太尼、丁丙诺非和氯诺西康用于颌面外科手术后PCIA中均有效。Objective： To assess the analgesia effect of patient controlled intravenous analgesia （PCIA） with different analgetics. Methods：296 patients underwent oral and maxillofacial operation and PCIA treatment postoperation,were divided into 8 groups according the medicine of PCIA. Group F were treated with fentanyl, group FD were treated with fentanyl＋droperidol, group FO were treated with fentanyl＋ondroperidol, group SF were treated with sufentanil, group SFO were treated with sufentanil＋ondroperidol, group B were treated with buprenorphine, group BO were treated with buprenorphine＋ondroperidol, and group L were treated with lornoxicam.The drugs used in all groups were diluted in 100mL saline seperately,background dose of 2mL/h,bolus 0.5mL,and lockout time was 15 min.The severity of pain,incidence of nausea and vomiting,and patient＇s satisfaction were analyzed statistically. Results： There was no significant difference in side-effecets among 8 groups. The incidence of nausea and vomiting was higher in intraoral operation than extraoral operation. Conclusion： The study suggests that fentanyl, sufentanil, buprenorphine and lornoxicam are effective in PCIA for oral and maxillofacial operation.

关 键 词：芬太尼 舒芬太尼 丁丙诺非 氯诺昔康 病人自控镇痛 

分 类 号：R782.2[医药卫生—口腔医学] R782.054[医药卫生—临床医学]