瑞芬太尼静脉自控镇痛在中期妊娠引产术中的应用  

Application of remifentanil in patient-controlled intravenous analgesia during midtrimester induction of labor

作　　者：孙冰[1] 张丕兴[1] 田瑞云[2] 孙静波[1] 纪绪师 王士雷[3] 

机构地区：[1]青岛市第八人民医院麻醉科,青岛266100 [2]青岛市第八人民医院妇科,青岛266100 [3]青岛大学医学院附属医院麻醉科,青岛266000

出　　处：《中国新药杂志》2009年第15期1410-1412,1439,共4页Chinese Journal of New Drugs

摘　　要：目的：通过对瑞芬太尼静脉自控镇痛及肌注哌替啶-非那根镇痛在中期妊娠引产术中的应用对比，探讨本研究中分娩镇痛方法的应用可行性。方法：选择中期妊娠引产孕妇50例，随机分为对照组（n=25）与试验组（n=25），试验组设置瑞芬太尼背景剂量0．033μg·kg^-1·min^-1，单次给药量0．4μg·kg^-1，锁定时间为2～3min，指导孕妇最好于宫缩来临前30～40S按压给药。记录术中孕妇生命体征、宫缩疼痛评分（VAS）、镇静评分（Ramsay）、恶心呕吐不良反应的发生及瑞芬太尼的用药量。结果：两组孕妇术中生命体征如血氧、血压、心率、呼吸频率比较差异无显著性，宫缩疼痛评分（VAS）比较差异有显著性（P〈0．01），说明试验组可提供有效镇痛。两组镇静评分（Ramsay）比较差异有显著性（P〈0．01）；无过度镇静病例。两组术中恶心呕吐发生率都较低，组间比较差异无显著性。结论：瑞芬太尼静脉自控镇痛用于中期妊娠引产术，孕妇生命体征平稳，镇痛效果确切，无过度镇静，恶心呕吐发生率较低。Objective： To evaluate and compare the effects of remifentanil in patient-controlled intravenous analgesia （PCIA） and intramuscular pethidine-phenergan analgesia during midtrimester induction of labor. Methods ： Fifty patients were randomly divided into control （n = 25） and remifentanil （PCIA, n = 25） groups. Control patients were treated with intramuscular pethidine and phenergan analgesia. PCIA patients were treated with remifentanil （background dose of 0.033μg·kg^-1·min^-1, single shot of 0.4μg·kg^-1, and the locked time about 2-3 min）, and the patients press the PCA system every 30-40 seconds before uterine contraction. The vital signs, visual analog scale （VAS） , mitigate scale （Ramsay） and adverse reactions （such as nausea and emesis） were recorded during the operation. Results：There were no significant differences between two groups in vital signs （ SPO2 , BP, HR and RR）. The VAS was significantly different in 2 groups （P 〈0.01 ） indicating the effective analgesia in PCIA group, and the Ramsay was also different in 2 groups（P 〈0.01 ） but no over-sedation was found. The incidence rates of adverse reactions （nausea and emesis） were low in both groups, and no significant differences were observed between 2 groups. Conclusion：Compared with the control, the vital signs are more stable, the analgesia is more effective and the adverse reactions are low in patients with PCIA. Thus, remifentanil PCIA is safe, effective and feasible during midtrimester induction of labor.

关 键 词：瑞芬太尼 静脉自控镇痛 中期妊娠引产术 

分 类 号：R971.2[医药卫生—药品] R969.4[医药卫生—药学]