围术期镇痛用药新模式与临床应用分析  

Analysis of New-type Usage of Analgesics and Clinical Use of It during Perioperative Period

作　　者：杨婉花[1] 何娟[1] 潘海燕[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院药剂科,上海200025

出　　处：《中国药房》2012年第6期507-509,共3页China Pharmacy

摘　　要：目的:评价我院外科手术镇痛药的应用情况,探讨合理的镇痛用药新模式,为临床合理用药提供参考。方法:随机抽取我院2009-2010年骨科、普外科和妇科手术前、后应用镇痛药的103份病历,分析各类镇痛药的应用情况和不良反应发生率及与其他药的合用情况。结果:在阿片类药和非甾体抗炎镇痛药(NSAIDs)中,术后应用率最高的为塞来昔布,其次为盐酸哌替啶注射液,二者分别占总病历数的45.63%、43.69%;不良反应发生率较低,主要是胃肠道反应如恶心、呕吐等(占5.83%),其次是便秘(占3.88%)。结论:超前镇痛模式(阿片类药和NSAIDs联用)能显著减少阿片类药的用量和恶心、呕吐、嗜睡、呼吸抑制等严重并发症,且能增强镇痛效果,加快起效时间,适合于临床推广。OBJECTIVE： To evaluate the use of analgesics during the perioperative period in our hospital and to probe into new-type usage of analgesics so as to provide reference for rational use and improve analgesic effect of analgesics. METHODS： The retrospective study was carried out in 103 patients from departments of osteology, general surgery and gynecology in our hospital during 2009 -- 2010, respectively. The clinical use of analgesics and the incidence of adverse drug reactions were analyzed, as well as the combination of analgesics with other medicine. RESULTS： Among opioid and NSAIDs, celecoxib was used most frequently, followed by meperi- dine hydrochloride, accounting for 45.63 % and 43.69 % ; adverse drug reactions like nausea and vomiting were not common, the inci- dence of which accounted for 5.83 %. The following reaction was constipation （3.88 % ）. CONCLUSION：Preoperative analgesic model （combination of opioids with NSAIDs） could significantly reduce the consumption of opioid and adverse drug reactions, such as nau- sea, vomiting, drowsiness, respiratory depression, and strengthen the effect of analgesics, shorten the onset time and be fit for extensive use in clinical practice.

关 键 词：镇痛 阿片类药 非甾体抗炎镇痛药 环氧酶-2抑制剂 不良反应 合理用药 

分 类 号：R969.3[医药卫生—药理学] R287[医药卫生—药学]