舒芬太尼不同给药速率对胸腔镜术后静脉镇痛的影响  

The Effect of Intravenous Analgesia after Video-assisted Thoracoscopic Surgery on Different Infusion Rates of Sufentanil

作　　者：张欢楷[1] 黄小贤[1] 杨文科[1] 张隆盛[1] 

机构地区：[1]广东省揭阳市人民医院麻醉科,522000

出　　处：《岭南急诊医学杂志》2014年第4期298-299,305,共3页Lingnan Journal of Emergency Medicine

摘　　要：目的:探讨舒芬太尼不同给药速率对胸腔镜术后静脉镇痛的有效性和不良反应。方法:将2012年1月2014年1月行胸腔镜手术的105例患者随机分成A组、B组、C组各35例,舒芬太尼的给药速率分别为3ug/h、4 ug/h、5 ug/h,在手术结束时即刻给予静脉连接PCLA泵,比较三组术后4 h、8 h、12 h、24 h的视觉模拟评分(VAS)、镇痛泵的有效按压次数、舒芬太尼用药总量和不良反应。结果:B组和C组的VAS评分、镇痛泵的有效按压次数及舒芬太尼用药总量均明显低于A组(P<0.05),但B组和C组无明显差异(P>0.05);C组的不良反应发生率明显高于B组和A组(P<0.05),但B组和A组无明显差异(P>0.05)。结论:舒芬太尼4 ug/h的静脉给药速率可为胸腔镜手术提供满意的术后镇痛效果且不良反应发生率低.Objective： To explore the efficacy and side effects of different infusion rates of sufentanil for patient- controlled intravenous analgesia （PCIA） after video-assisted thoracoscopic surgery （VATS）. Method： 105 cases treated by VATS were randomly divided into group A, group B and group C from Jan 2012 to Jan 2014, and each group was 35 cases. After the injection of a bolus of 5 micrograms sufentanil, the infusion rate of snfentanil in group A,group B, group C were 3 ug/h,4 ug/h,5 ug/h respectively. Visual analogue score （VAS）,the effective pressing numbers, the total dosage of snfentanil and adverse effects were compared at 4 h,8 h,12 h and 24 h after the surgery. Results： The VAS score, the effective pressing numbers and the total dosage of sufentanil in group B and group C were significantly lower than those in group A（P 〈 0.05）, but no different between group B and group C（P 〉 0.05）. The adverse effects were not significant difference between group A and group B （P 〉 0.05）,but the incidence rate of adverse effects in group C were significantly higher than those in group A and group B （P 〈 0.05）. Conclusion： The study shows that 4ug/h sufentanil for PCIA after VATS is an effective method with less side effects.

关 键 词：舒芬太尼 给药速率 静脉镇痛 胸腔镜手术 

分 类 号：R614[医药卫生—麻醉学]