小剂量芬太尼耳穴注射预防烧伤创面换药操作痛效果观察  

Prevention of procedural pain in dressing changes of burn wounds by auricular injection of smalldose fentanyl

作　　者：张尚华[1] 刘英飞[1] 刘斌[1] 朱红霞[2] 苏心镜[2] 

机构地区：[1]河北北方学院附属第二医院普外科,宣化075100 [2]河北北方学院附属第二医院麻醉科,宣化075100

出　　处：《中国针灸》2014年第10期972-974,共3页Chinese Acupuncture & Moxibustion

摘　　要：目的:探寻防治烧伤创面换药操作痛的有效疗法。方法:将90例烧伤患者随机分为3组,每组30例。Ⅰ组取耳穴创面相应部位、交感、肺、内分泌,每穴注射枸橼酸芬太尼注射液0.25mL;Ⅱ组予上臂三角肌处皮下注射枸橼酸芬太尼注射液1mL,Ⅲ组予上臂三角肌处皮下注射0.9%氯化钠注射液1mL。以视觉模拟评分法(VAS)评价3组患者换药前、换药中及换药后10min的镇痛效果。结果:3组患者换药前VAS评分差异无统计学意义(P>0.05);与换药前比较,Ⅰ组患者换药中及换药后创面无明显痛感,VAS评分差异无统计学意义(均P>0.05),而Ⅱ组、Ⅲ组患者换药中及换药后创面有痛感,VAS评分差异有统计学意义(均P<0.05);Ⅰ组患者换药中及换药后VAS评分低于Ⅱ组、Ⅲ组(均P<0.05),且Ⅱ组低于Ⅲ组(P<0.05)。结论:小剂量芬太尼耳穴注射用于预防烧伤创面换药操作痛镇痛效果确切,优于芬太尼皮下注射。Objective To explore the effective method of the prevention and treatment of procedural pain in dressing changes of burn wounds. Methods Ninety patients of burn injury were randomized into 3 groups, 30 ca- ses in each one. In the group A, fentanyl citrate injection was used at corresponding injury area, j iaogan （AH6a, sympathetic nerve）, fei （CO14 , lung）, neifenmi （CO18, endocrine） on ear, 0.25 mL at each point. In the group B, fentanyI citrate injection was applied subcutaneously in the deltoid muscle, 1 mL. In the group C, 0.9% sodium chloride injection was applied subcutaneously in the deltoid muscle, 1 mL. The visual analogue scale （VAS） was used to evaluate the analgesic effect before, during and 10 min after dressing change in the patients of the three groups separately. Results It was not different in VAS score before dressing change among the three groups （P〉 0.05）. Compared with that before dressing change, the pain was not significant and VAS score was not different during and after dressing change in the patients of the group A （both P〉0.05）, but the score in the patients of the group B and C was different significantly （all P〈0.05）. The VAS score during and after dressing change in the group A was lower than that in the group B and C （all P〈0.05）, and the score in the group B was lower than that in the group C （P〈0.05）. Condusion Fentanyl injection of small dose at auricular points achieves definite analgesic effect on proce- dural pain in dressing changes of burn wounds, superior to subcutaneous injection of fentanyl.

关 键 词：烧伤创面换药 操作痛 穴位注射 耳穴 芬太尼 

分 类 号：R246.2[医药卫生—针灸推拿学]