机构地区:[1]福建省泉州市解放军第180医院麻醉科,362000 [2]首都医科大学附属北京朝阳医院麻醉科
出 处:《国际麻醉学与复苏杂志》2012年第8期509-512,共4页International Journal of Anesthesiology and Resuscitation
基 金:基金项目:国家自然科学基金资助项目(81171055);北京市自然科学基金(7112054)
摘 要:目的评价普瑞巴林对下腹部手术患者术后镇痛的影响。方法采用完全随机分组、安慰剂对照研究方法,择期行下腹部手术患者30例,年龄19岁一60岁,美国麻醉医师协会(ASA)分级I或Ⅱ级,随机分为两组(每组15例):普瑞巴林组(P组)和对照组(c组)。患者麻醉前30min,P组口服普瑞巴林胶囊75mg,C组口服自制面粉胶囊。两组患者常规麻醉诱导,术中静脉泵注瑞芬太尼和异丙酚,按需追加肌松药维持麻醉。两组患者术后均采用患者静脉自控镇痛(patient-controlledintravenousanalgesia,PCIA),并于术后2,4、8、12、20、24h等时点,采用视觉模拟评分法(VAS)评价患者静息痛和咳嗽痛的程度。记录术后2、4、8、12、20、24h等时点PCIA有效次数和总次数,及术后镇痛药液累计耗量;记录术后副作用的发生情况。结果30例患者均完成试验。与术后2h时比较,两组术后4、8、12、20、24hPCIA有效次数和总次数差异有统计学意义(P〈0.05);与C组比较,P组术后各时点静息痛VAS评分【(5.3±0.5)、(4.5±0.6)、(3.7±o.6)、(2.5±0.8)、(1.4±0.5)、(0.8±0.4)】和咳嗽痛VAS评分I(7.3±0.6)、(6.5±0.7)、(5.5±0.5)、(4.6±0.8)、(3.3±0.5)、(2.9±0.4)1均低于C组【(6.3±0.7)、(5.8±0.6)、(4.9±0.5)、(4.3±0.6)、(2.5±0.7)、(1.9±0.3)】和【(8.1±0.5)、(7.7±0.5)、(7.0±±0.4)、(6.3±0.6)、(4.5±0.6)、(3.9±0.5)】(P〈0.05),术后各时点PCIA有效次数【(2.0±0.4)、(3.3±0.7)、(3.9±1.1)、(3.9±1.1)、(3.9±1.1)、(3.9±1.1)】和总次数【(2.5±0.7)、(3.9±1.0)、(4.5±1.4)、(4.5±1.4)、(4.5±1.4)、(4.5±1.4)1降低,镇痛药液耗量显著减少(PObjective To investigate the effects of pregabalin on the postoperative analgesia in patients with lower abdominal surgery. Methods The patients aged 19-70, ASA I -II, scheduled for lower abdominal surgery were randomly divided into 2 groups (n=15): Group P (pregabalin) and Group C(control). The patients in Group P and C orally took pregabalin (75 mg) or self-made flour capsule 30 min prior to general anesthesia, respectively. General anesthesia was routinely induced and maintained with remifentanil, propofol and muscle relaxant. Patient-eontrolled intravenous analgesia (PCIA) was used in every patient. The rest pain and cough pain was assessed using vision analogue scale (VAS) at 2, 4, 8, 12, 20 h and 24 hatier surgery,respectively. The effective and total numbers of PCIA, analgesic comsumption and side-effects were recorded in postoperative 24 h. Results All 30 patients completed the trial. Compared with postoperative 2 h postoperative 4, 8, 12, 20, 24 h, the PCIA effective frequency and the total number of difference was statistically significant(P〈0.05), Compared with group C[(6.3±0.7), (5.8±0.6), (4.9±0.5), (4.3±0.6), (2.5±0.7), (1.9±0.3)and(8.1±0.5), (7.7±0.5), (7.0±0.4), (6.3±0.6), (4.5±0.6), (3.9±0.5)], VAS during rest [(5.3±0.5), (4.5±0.6), (3.7±0.6), (2.5±0.8), (1.4±0.5), (0.8±0.4)] and cough[(7.3±0.6), (6.5±0.7), (5.5±0.5), (4.6±0.8), ( 3.3±0.5 ), (2.9±0.4) ]at each time point postoperation were lower(P〈0.05 ). Postoperative effective frequency[(2.0±0.4), ( 3.3±0.7 ), (3.9±1.1), (3.9±1.1), (3.9±1.1), (3.9±1.1)]and the total number[(2.5±0.7), (3.9±1.0), (4.5±1.4), (4.5±1.4), (4.5±1.4), (4.5±1.4)] of PCIA were lower in group P than that in group C(P〈0.05). Only nausea and vomiting were observed as post operation side effects, and there was no significant difference between the two gro
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