恩再适预镇痛对芬太尼用于术后静脉镇痛的临床效应  

Clinical effect of postoperative injection of Analgecine on patient-controlled intravenous analgesia of Fentanyl

作　　者：吴世民 张咸伟[2] 温伟浩 

机构地区：[1]福永人民医院麻醉科,深圳518103 [2]华中科技大学同济医学院附属同济医院麻醉学教研室,武汉

出　　处：《中国临床实用医学》2008年第2期9-11,共3页China Clinical Practical Medicine

基　　金：深圳市宝安区科技计划项目（项目编号：2007E022）

摘　　要：目的比较术前预用恩再适对不同剂量芬太尼用于子宫全切术后患者自控静脉镇痛的影响。方法选择全麻下子宫全切术的患者120例，术后采用芬太尼经生理盐水稀释后行患者自控静脉镇痛（PCIA），并根据不同的用药方法随机分为四组：A组，芬太尼1mg＋0．9％NaCl共100ml；B组，芬太尼0．5mg＋0．9％NaCl共100ml；C组，术前晚、麻醉前、术毕各经静脉注射恩再适3．6U，芬太尼0．7mg＋0．9％NaCl共100ml；D组，术前晚、麻醉前、术毕各经静脉注射恩再适7．2U，芬太尼0．5mg＋0．9％NaCl共100ml，每组30例。术后24h内采用视觉模拟评分（VAS）、PCA按压次数来观察各组镇痛效应及恶心呕吐、嗜睡等不良反应的发生率。结果B组术后2h时的VAS评分显著高于A、C和D组（P〈0．05），而2h后的VAS四组间差异无统计学意义（P〉0．05）。24h内的PCA按压次数B组显著多于A、C和D组（P〈0．05）。B、C和D组中恶心、呕吐、皮肤瘙痒及嗜睡等不良反应的发生率显著低于A组（P〈0．05）。镇痛期间无呼吸抑制、异常出血等严重并发症的发生。结论术前预用恩再适复合小剂量芬太尼用于子宫全切术后静脉镇痛可取得满意的镇痛效果，并能减少芬太尼的用量及不良反应的发生率。Objective To compare the effect of preoperative intravenous injection of Analgecine on the analgesic efficacy and complications of patient-controlled intravenous analgesia（PCA） of different doses of fentanyl in postoperative total hysterectomy patients. Methods 120 patients undergoing total hysterectomy in general anesthesia were randomly divided into four groups with thirty cases each. Fentanyl 1 mg in group A ,fentanyl 0.5 mg in group B,fentanyl 0. 7 mg in group C ,fentanyl 0.5 mg in group D. The drugs in each group were diluted to 100 ml and infused by pumps. Besides,the patients in group C and D were injected with Analgecine 3.6 U and 7.2 U at the night before the operation, preoperation and postoperation respectively. The visual analog scale （VAS） ,times of PCA and incidence of side effects were recorded during the period of postoperative 24 hours. Results The VAS of group B at 2 h after operation was significantly higher than that of group A,C and D（P 〈0.05） ,which became similar 2 h later（P〉0.05）. The demanding times for supplemental bolus in group B was also significantly higher than that of A, C and D （P〈0.05）. The incidence of nausea, vomiting, itching, somno-lence in group B, C and D were significantly less than those in group A （P〈0.05）. No respiratory depression or abnormal bleeding occurred in four groups. Conclusion Preoperative intravenous injection of Analgecine has a better effect on patient-controlled intravenous analgesia（PCIA）of fentanyl and can reduce fentanyl requirement and its side effects in total hysterectomy patients.

关 键 词：恩再适 芬太尼 镇痛 静脉 子宫全切术 

分 类 号：R614[医药卫生—麻醉学]