丙帕他莫联合氟比洛芬酯、舒芬太尼对烧伤切痂植皮术后镇痛的效果观察  

Postoperative analgesia by propacetamol combined with flurbiprofen axetil and sufentanyl on burned patients

作　　者：胡跃丽 卓阳 胡陈鳞 陈丽芬 李荣金 杜剑鸿 包文敏 赵苗珍 

机构地区：[1]解放军第118医院,浙江省温州325000

出　　处：《现代实用医学》2011年第3期253-255,共3页Modern Practical Medicine

基　　金：全军医药卫生科研项目(09MA025)

摘　　要：目的观察丙帕他莫联合氟比洛芬酯、舒芬太尼对烧伤切痂植皮术后镇痛的效果。方法将60例烧伤切痂植皮术后患者按随机数字表法随机分为A、B及C组,各20例。A组负荷剂量为舒芬太尼5 g,镇痛泵用药为舒芬太尼150 g+0.9%氯化钠注射液稀释至100 ml;B组负荷剂量为氟比洛芬酯50 mg,镇痛泵用药为氟比洛芬酯100 mg+舒芬太尼100 g+0.9%氯化钠注射液稀释至100 ml;C组术毕前15 min静脉滴注盐酸丙帕他莫2 g(加入100 ml0.9%氯化钠注射液中,15 min内滴完),负荷剂量为氟比洛芬酯50 mg,镇痛泵用药为氟比洛芬酯100 mg+舒芬太尼100 g+0.9%氯化钠注射液稀释至100 ml。3组镇痛泵均设置维持量2ml/h,单次负荷剂量0.5 ml,锁定时间15 min。记录3组术后2、6、12、24及48 h患者安静和活动时的疼痛视觉模拟评分(VAS)及不良反应情况。结果 3组患者安静和活动时均获得满意的镇痛效果,术后2及6 h安静与活动时VSA C组均要小于A、B组,差异均有统计学意义(均<0.05)。3组不良反应发生率差异有统计学意义(<0.05),A组不良反应的发生率显著高于B、C组(均<0.05)。结论在烧伤切痂植皮术后,丙帕他莫联合氟比洛芬酯、舒芬太尼在镇痛效果上更优,且安全有效,不良反应少。Objective Toobserve theeffects andsideeffectsofpostoperative analgesiaby propacetamolcombined with flurbiprofen axetil and sufentanyl on burned patients undergoing burn wound excision and skin grafting.Me-thods 60 cases were randomly divided into 3 group,with 20 cases in each group.In group A,the load dose of suf-entanyl was 5 g,and for the pump,there were sufentanyl（150 g）＋0.9% sodium chloride solution diluting to 100 ml.In group B,the load dose of flurbiprofen axeti was 50 mg,and flurbiprofen axeti 100 mg＋sufentanyl 100 g＋0.9% sodium chloride solution diluting to 100 ml were infused.In Group C,15 minutes before completing operationi,ntra-venous dripping 2 g of propacetamol were performanced（with 100 ml of sodium chloride solution,15 min）;the the load dose of sflurbiprofen axeti was 50 mg,and flurbiprofen axeti（100 mg）＋sufentanyl（100 g）＋0.9% sodium chlor-ide solution diluting to 100 ml were infused.The maintenance dose was 2 ml/h with single load dose of 0.5 ml and lock time of 15 minutes.After operation,the visual analogue scales（VAS） of quiet and activities after 2,6,12,24 and 48 hours were recorded;and the adverse reactions were compared.Results All the results in three groups are sati-sfying.After 2 and 6 hours,the scores of quiet and activities in group C were lower than those of group A and B（ 0.05）.There were statistical significances among 3 groups in adverse reactions（ 0.05）.Conclusions After undergoing burn wound excision and skin grafting,it is more more efficiently and security in analgesia by propaceta-mol combined with flurbiprofen axetil and sufentanyl.

关 键 词：丙帕他莫 氟比洛芬酯 舒芬太尼 烧伤 术后镇痛 多模式镇痛 

分 类 号：R614[医药卫生—麻醉学]