酮咯酸氨丁三醇联合舒芬太尼在胸科术后镇痛的临床应用观察  

Clinical application of ketorolac tromethamine combined with sufentanil to analgesia after thoracic surgery

作　　者：缪小勇[1] 徐晶鸿[2] 徐葭[1] 查燕萍[1] 曹建平[1] 

机构地区：[1]解放军第455医院麻醉科,上海200052 [2]解放军第455医院药剂科,上海200052

出　　处：《临床军医杂志》2014年第3期263-265,共3页Clinical Journal of Medical Officers

摘　　要：目的探讨酮咯酸氨丁三醇联合舒芬太尼在胸科术后镇痛的临床效果。方法择期行胸科手术患者68例，ASAⅠ～Ⅱ级，随机分为S及Ks两组，s组为舒芬太尼镇痛组，关胸时静脉给予舒芬太尼5μg，镇痛泵配方：舒芬太尼0．1mg＋0．9％生理盐水至100ml。KS组为酮咯酸氨丁三醇联合舒芬太尼镇痛组，关胸时静脉给予酮咯酸氨丁三醇30mg，镇痛泵配方：酮咯酸氨丁三醇90mg＋舒芬太尼5μg＋0．9％生理盐水至100ml。两组镇痛泵设定给药模式一样，单次剂量0．5ml，锁定时间15min，背景剂量2ml／h。记录两组术后2、4、8、16、24、48h静态和动态疼痛评分，观察两组的不良反应和患者自控镇痛的按压次数及患者的满意度。结果两组患者在术后各时点静态VAS评分无统计学差异（P〉0．05）。与s组比较，Ks组在术后各时点动态VAS评分和不良反应发生率低，自控镇痛的按压次数少，患者的满意度高（均P〈0．05）。结论酮咯酸氨丁三醇联合舒芬太尼用于胸科手术后静脉镇痛与单用舒芬太尼镇痛比较，镇痛效果佳，患者满意度高，不良反应发生率低。Objective To study the clinical effect of ketorolac tromethamine combined with sufentanil on postoperative analgesia in the patients who had just undergone thoracic surgery. Methods A total of 68 patients （ ASA Ⅰ-Ⅱ ） selective to undergo thoracic surgery under general anesthesia were randomized into Group S （ intravenous sufeutanil analgesia） and Group KS （ ketorolac tromethamine plus sufentanil analgesia）. Group S received intravenous sufentanil 5 Ixg on chest closure （ the formula of analgesia pump was sufentanil 0. 1 mg＋ 0. 9% sodium chloride to 100 ml）. In addition, Group KS received intravenous ketorolac tromethamine 30 mg on chest closure （ the formula of analgesia pump was ketorolac tromethamine 90 mg＋ sufentanil 5 μg ＋ 0.9% sodi- um chloride to 100 ml）. Analgesic pumps were set at the same modal in the two groups with a single dose of 0.5 ml, locking time of 15 rain and background dose of 2 ml/h. The static and dynamic visual analog score （VAS） at 2-,4-,8-, 16-,24- and 48- h were assessed. The press times for self- control analgesia, as well as the satisfaction degree and perioperative adverse events, was recor- ded. Results The two groups were of no statistical difference in VAS at every time point （ P 〉 0.05 ）. Compared with that of Group S, the dynamic VAS score and adverse event rate of Group KS were lower （P 〈 0.05）. The press times and satisfaction de- gree were significantly higher in Group KS than in Group S （ P 〈 0.05 ）. Conclusion Ketorolac tromethamine combined with sufentanil provides good analgesia and satisfaction degree, with less adverse events.

关 键 词：酮咯酸氨丁三醇 舒芬太尼 胸科手术 术后镇痛 

分 类 号：R971.1[医药卫生—药品]