萘普生钠联合舒芬太尼在上肢手术术后静脉镇痛中的应用  

The application of Percutaneous continuous intravenous analgesia with naproxen sodium combined with sufentanil after upper extremity surgery

作　　者：胡志强 武斌 吴树辉 黄勇辉 

机构地区：[1]广东省新兴县中医院麻醉科,广东新兴527400

出　　处：《岭南现代临床外科》2014年第5期537-539,542,共4页Lingnan Modern Clinics in Surgery

摘　　要：目的 观察萘普生钠联合舒芬太尼在上肢手术术后自控静脉镇痛中（PCIA）的效果.方法 选择ASA Ⅰ～Ⅱ级择期行锁骨和上肢手术的患者90例,均采用臂丛神经阻滞,麻醉效果满意,术后行PCIA,随机分为三组：芬太尼组（F组）、舒芬太尼组（SF组）、萘普生钠联合舒芬太尼组（SF＋N组）,每组30例.3组PCIA配方分别是：①F组：芬太尼20 μg/kg＋盐酸昂丹司琼0.15 mg/kg,加生理盐水稀释至100 mL;②SF组：舒芬太尼2.0 μg/kg＋盐酸昂丹司琼0.15 mg/kg,加生理盐水稀释至100 mL;③SF＋N组：舒芬太尼1.5 μg/kg＋萘普生钠10 mg/kg＋盐酸昂丹司琼0.15mg/kg,加生理盐水稀释至100 mL.观察3组患者术后2、6、12、24、48 h视觉模拟评分（VAS）、镇静程度评分（Ramesy）、48 h内患者自控镇痛（PCA）按压次数及不良反应的情况.结果 3组配方均能为患者提供良好的术后镇痛,3组患者总的PCA按压次数差异无统计学意义.SF＋N组患者的VAS评分、Ramesy镇静评分与另二组无显著差异（P＞0.05）,但患者术后的不良反应SF＋N组显著少于F组和SF组（P＜0.05）,总体满意度高.结论 萘普生钠联合舒芬太尼用于上肢手术术后静脉镇痛,镇痛效果确切、副作用低和满意度高.Objective To evaluate the analgesia effect of patient controlled intravenous analgesia （PCIA） with naproxen sodium and sufentanil in upper extremity surgery. Methods Ninety patients with ASA Ⅰ - Ⅱ that were scheduled for clavicular and upper extremity surgery under brachial plexus retardation, and treated with PCIA after the surgery. The patients were randomized into three group, fentanyl group （Group F, n=30）, sufentanil group （group SF, n=30） and uaproxen sodium＋sufentanil group （group SF＋N, n=30）. PCIA gradients used for each group are as follow： fentanyl 20μg/kg＋ ondansetron hydrochloride 0.15 mg/kg for group F, sufentanil 2.0 μg/kg＋naproxen sodium 0.15 mg/kg for group SF; Sufentanil 1.5 μg/kg＋ naproxen sodium 10 mg/kg＋ondansetron hydrochloride 0.15 mg/kg for group SF＋N,which were diluted to be 100 ml by adding saline. VAS, Ramesy scores and pressing times of PCA equipment,side effects as well as patient＇s satisfactory degree were recorded and compared among 3 groups. Results There was no significant difference in pressing times of PCA equipment. And SF＋N group showed no significant different outcome regarding to the VAS score, Ramesy score and when compared with group F and group SF （P〉0.05）. Group SF＋N showed significantly higher satisfactory degree as compared to group F and group SF （P〈0.05）. Conclusion Naproxen sodium combining with sufentanil in PCIA exhibits better clinical effect with less side effects and higher satisfactory degree for patients.

关 键 词：萘普生钠 舒芬太尼 上肢 静脉镇痛 

分 类 号：R619[医药卫生—外科学]