东莨菪碱用于乳腺癌术后硬膜外自控镇痛的临床研究  

Efficacy of scopolamine on patient controlled epidural analgesia after breast cancer operation

作　　者：李爱香[1] 王建荔[2] 

机构地区：[1]河南大学淮河医院,475000 [2]广西医科大学附属肿瘤医院

出　　处：《中国医学创新》2010年第20期70-72,共3页Medical Innovation of China

摘　　要：目的研究东莨菪碱对乳腺癌术后硬膜外自控镇痛镇痛镇静效果的影响,及其对术后恶心呕吐的预防治疗作用。方法选择乳腺癌手术患者48例,随机分为东莨菪碱组(S组)和对照组(C组),S组采用东莨菪碱1.8 mg+丁丙诺啡0.6 mg+布比卡因300 mg;C组用丁丙诺啡0,6 mg+布比卡因300 mg,行硬膜外自控镇痛。分别于术后2 h、8 h、24 h、48 h各时点行VAS镇痛评分、Ramsay镇静评分,并对两组患者有效PCA按压次数及不良反应进行观察记录。结果 (1)两组患者镇痛镇静效果均满意,组间比较不同时点Ramsay镇静评分差异无统计学意义(P>0.05);术后各时点VAS评分S组低于C组(P<0.05),C组有效PCA按压次数多于S组(P<0.05)。(2)S组术后恶心呕吐发生率低于C组(P<0.05),其他不良反应差异无统计学意义(P>0.05)。结论东莨菪碱可提高乳腺癌术后硬膜外自控镇痛的镇痛效果,对术后恶心呕吐具有预防治疗作用。Objective To evaluate the efficacy of scopolamine on analgesic and sedative potency of patient controlled epidural analgesia（PECA） after breast cancer operation, to observe it＇s effect to prevent postoperative nausea and vomiting （PONV）. Methodls Forty eight patients, undergoing breast cancer operation were selected and rando rely divided into scopolamine group （groupS） and controll group （ group C）. Group S received scopolamine 1.8mg ＋ Buprenorphine 0.6 mg ＋ Bupivacaine 300 mg;Group C received Buprenorphine 0.6 mg ＋ Bupivaeaine 300 mg. The PCEA were administrated after operation. The effect of analgesic and sedation were assessed by visual analogue score（VAS） and Ramsay sedation score respectively at 2 h,8 h,24 h,48 h after operation. The frequencies of effective PCA and side effects were recorded. Results （ 1 ） The effeets of sedation and analgesia in two groups were satisfactory,There were no significant difference in Ramsay sedation score between two groups（ P 〉 0.05 ） ;Group S had significantly lower VAS score than Group C （P 〈 0.05 ） ;The frequencies of effective PCA in group C was significantly more than that in group S （ P 〈 0.05 ）. （ 2 ） Incidence of postoperative nausea and vomiting was significantly lower in group S than in group C （ P 〈 0.05 ）. No differences existed in Other side effects between two groups （ P 〉 0.05 ）. Conclusion Scopolamine can improve the analgesia potency of patient controlled epidural analgesia and reduce the incidence of PONV.

关 键 词：东莨菪碱 硬膜外自控镇痛 镇痛 镇静 术后恶心呕吐 

分 类 号：R614[医药卫生—麻醉学]