喷他佐辛用于非停跳冠状动脉搭桥患者术后静脉镇痛的效果  

Effect of pentazocine on postoperative intravenous analgesia in patients undergoing off-pump coronary ar. tery bypass grafting operation

作　　者：赵文度[1] 张亮[1] 卢家凯[1] 程卫平[1] 

机构地区：[1]首都医科大学附属北京安贞医院麻醉科,100029

出　　处：《中国医药》2014年第1期17-20,共4页China Medicine

摘　　要：目的观察非体外循环冠状动脉搭桥术后喷他佐辛的镇痛效果。方法选取64例择期行非体外循环冠状动脉搭桥术男性患者，将其完全随机分为芬太尼组、喷他佐辛1组、喷他佐辛2组和喷他佐辛3组，每组16例，分别用喷他佐辛0．50、0．75、1．00ug/kg加0．9％氯化钠溶液至200ml。芬太尼组用芬太尼2mg加0．9％氯化钠溶液至200m1，每组均以2ml／h的速度持续静脉泵入。记录患者连接止痛泵后4、8、12、24、36、48、72、96h的视觉模拟评分（VAS）、Ram—Say镇静评分，不良反应和要求追加止痛剂的情况。结果喷他佐辛1组8h和12hVAS评分[（2．4±1．2）、（3．2±1．8）分]高于芬太尼组和喷他佐辛2、3组[（1．7±1．0）、（1．7±1．1）分；（1．9±1．1）、（1．9±1．2）分；（1．8±1．2）、（1．7±0．9）分]，差异均有统计学意义（均P〈0．05）。喷他佐辛1组镇痛优良率为68．7％（11例），喷他佐辛3组的镇痛优良率[100．0％（16例）]高于芬太尼组[87．5％（14例）]（P〈0．05）。结论0．75ug/kg喷他佐辛用于术后镇痛效果可靠，且不良反应发生率低于芬太尼，更适用于非体外循环冠状动脉搭桥术。Objective To observe the analgesic effect of pentazocine after off-pump coronary artery bypass grafting operation. Methods All 64 elective male patients undergoing off-pump coronary artery bypass grafting operation were randomized divided into fentanyl group （ group F, n = 16 ） and pentazocine group P1 （ n = 16 ）, group P2（n = 16） and group P3（n = 16） group. In group F, 2 mg fentanyl was diluted into 200 ml with saline. Each group had continuously intravenous infusion at the speed of 2 ml/h. Visual analogue scale （VAS）, Ramsay sedation score, total analgesic comfortable score, adverse reactions and additional analgesics were recorded at 4, 8, 12, 24, 36, 48, 72, 96 h after the analgesia pump was connected to patient. Results VAS score of group P1 [ （ 2.4 ± 1.2）, （ 3.2 ± 1.8 ） scores ] was higher than that of other groups at 8 h and 12 h （ P 〈 0.05 ）. The analgesic excellent rate of group P1 was 68.7% （11/16） and the analgesic excellent rate of pentazoeine group was higher than fentanyl group[100.0% （16 cases） vs 87.5% （14 cases）, P〈0.05]. Conclusion Pentazoeine can produce reliable postoperative analgesia for patients undergoing after off-pump coronary artery bypass grafting operation and the rate of adverse reactions is lower than fentanyl.

关 键 词：非体外循环冠状动脉搭桥术 喷他佐辛 镇痛 

分 类 号：R614.2[医药卫生—麻醉学]