高乌甲素用于术后患者自控皮下镇痛对血浆β-内啡肽的影响  

Clinical study of Lappaconitine for postoperative patient-controlled subcutaneous analgesia on plasma β-endorphin

作　　者：杨丛忠 刘玉莲[1] 宋正良[1] 王开祥[2] 

机构地区：[1]山东省滕州市红十字中医院,山东滕州277500 [2]山东省滕州市中心人民医院,山东滕州277500

出　　处：《中国医药导报》2010年第24期17-19,共3页China Medical Herald

摘　　要：目的:观察高乌甲素用于术后患者自控皮下镇痛(PCSA)的疗效和安全性。方法:选择80例普胸手术患者,随机分为两组,各40例,高乌甲素组(L组)和吗啡组(M组)。L组配方:高乌甲素26mg+地塞米松10mg+利多卡因200mg+NS共100ml,术后行PCSA。M组配方:吗啡40mg+氟哌利多5mg+NS共100ml,术后行PCIA。两组均选用一次性使用输注泵,型号规格:持续给药+自控给药型WZ-6523C-4,标准流量:2.0ml/h,自控给药剂量0.5ml,自控给药间隔时间:15min。分别于术后6、12、24、48h时间点用视觉模拟评分法(VAS)和Prince-Henry法评价疼痛的程度和疗效,并统计两组不良反应的发生率。随机在各组选择10例患者,在以上各时点抽前臂静脉血2ml加入含1%肝素20U和抑肽酶2000U塑料试管内,离心后取血浆-40℃保存,用放免法测定血浆β-内啡肽的含量。结果:两组间在术后各时点疼痛的程度稍有差别,但差异无统计学意义(P>0.05);而两组间部分不良反应的发生率比较,差异有非常统计学意义(P<0.01);两组间血浆β-EP的含量比较,差异无统计学意义(P>0.05)。结论:高乌甲素用于PCSA镇痛效果确切,不仅与吗啡接近,而且不良反应少。Objective：To observe the efficacy and safety of the Lappaconitine for postoperative patient-controlled subcutaneous analgesia（PCSA）.Methods：80 cases of thoracic surgery patients,40 cases were randomly divided into two groups,Lappaconitine（group L） and Morphine（group M）.L recipes：Lappaconitine 26 mg＋ Dexamethasone 10 mg＋ lidocaine 200 mg＋NS were 100 ml,postoperative PCSA.M recipes：Morphine 40 mg＋droperidol 5 mg＋NS were 100 ml,postoperative PCIA.Both groups used disposable infusion pump,model specifications：continuous administration of controlled drug delivery-type＋WZ-6523C-4,standard flow rate：2.0 ml/h,controlled dose 0.5 ml,self-control to the solution interval：15 min.Respectively after 6 h,12 h,24 h,48 h with visual analogue scales（VAS） and the Prince-Henry method to evaluate the degree of pain and efficacy,and the incidence rate of adverse reactions in two groups were calculated.And randomly selected 10 cases in each group of patients,the forearm blood pumping more than 2 ml at each time point by adding in the plastic tubes including 1% heparin 20 U containing aprotinin 2 000 U and plasma after centrifugation -4℃ preservation,measured by radioimmunoassay in plasma β-endorphin（β-EP） content.Results：The mean postoperative pain level of each point in time slightly different,but no statistical significance（P0.05）; in the two groups the incidence of some adverse reactions had a very significant difference（P0.01）; plasma β-EP content of the two groups was no significant difference（P0.05）.Conclusion：Lappaconitine PCSA exact analgesia,Morphine not only close,but few ad- verse reactions.

关 键 词：患者自控皮下镇痛(PCSA) 高乌甲素 血浆Β-内啡肽 

分 类 号：R614[医药卫生—麻醉学]