鼻内镜术后芬太尼自控镇痛的临床观察  

The Effect of Fentanyl for Patient-controlled Analgesia after Functional Endoscopic Sinus Surgery

作　　者：李丽[1] 林娜[1] 李天佐[1] 

机构地区：[1]首都医科大学附属北京同仁医院麻醉科,100730

出　　处：《医学研究杂志》2008年第10期74-75,共2页Journal of Medical Research

摘　　要：目的鼻内镜手术后使用芬太尼进行病人自控镇痛(PCA),观察其镇痛效果及不良反应。方法成年男性患者101例,ASAⅠ-Ⅱ,随机分为无镇痛组和芬太尼病人自控镇痛组,择期全麻下行鼻内镜手术。芬太尼组PCA设置:背景量0.1μg/(kg.h),单次剂量0.4μg/(kg.min),锁定时间15min,每天最大剂量600μg。术后48h内随访观察病人的一般情况、疼痛、头晕、恶心呕吐、食欲及睡眠等指标。结果两组患者次日晨和24h的VAS差异具有统计学意义(P<0.05)。术后6h和48h两组VAS比较无统计学差异(P>0.05)。术后6h芬太尼组的镇静程度明显高于无镇痛组(P<0.01)。两组患者术后睡眠、食欲、头晕以及PONV的发生率均无统计学差异。结论鼻内镜手术后镇痛使用芬太尼行静脉PCA,镇痛效果确实,不良反应少,但术后镇静程度较高,需加强护理及监测。Objective To observe the analgesic effects and the side effects of fentanyl after the FESS with general anesthesia. Methods 101 adult male patients, ASA Ⅰ-Ⅱ, undergoing elective FESS were divided into two groups randomly, received fentanyl through PC A or no analgesia. The PCA device was set at background infusion 0. 1μg/（ kg·h） , bolus dose 0.4μg/kg·time, lockout time 15 minutes. The maximum dose is 600μg per day. Virtual signs, VAS, Ramsay sedation, dizzy, nausea, vomit and appetite were observed after the operation for two days. Results The VAS of the two groups is significant different in the time of the second morning and 24 hours later after the operation （P〈0.05）. At the point of 6 hours after operation, the sedation score in fentanyl group is more higher than that in no anagesia group（P〈0.01）. No difference between the two groups in dizzy. The accident of postoperative nausea and vomit is similar between the two groups. Conclusion After the FESS, using PCA with fentanyl can provide a good analgesia and make the patients more comfortable. Because the sedation score is higher with fentanyl, more attention should be paid to those patients.

关 键 词：芬太尼 鼻内镜手术 病人自控镇痛 

分 类 号：R614[医药卫生—麻醉学] R765.9[医药卫生—外科学]