芬太尼静脉自控镇痛对糖尿病患者术后血糖水平的影响  

Effects on Blood Glucose Levels in Diabetic Patients Controlled Intravenous Analgesia with Fentanyl in Patients after Surgery

作　　者：朱炬[1] 

机构地区：[1]济宁医学院附属医院麻醉科,山东济宁272000

出　　处：《糖尿病新世界》2015年第12期48-49,共2页Diabetes New World Magazine

摘　　要：目的观察芬太尼静脉自控镇痛对糖尿病患者术后血糖水平的影响。方法选取2014年1月—2014年12月期间到该院行手术治疗且符合2型糖尿病诊断标准的190例患者,随机分为对照组和观察组各95例,两组患者血糖均控制于7~10 mmol/L,尿酮阴性后方可进行手术,均采取静吸复合麻醉方式,术后患者清醒返回病房后进行预防性镇痛。观察组采用芬太尼静脉自控镇痛,芬太尼1.5 mg用生理盐水稀释至150 mL,使用自控型镇痛泵按2 mL/h恒速输注,并根据患者疼痛评定情况随时调整输注速度。对照组采用口服盐酸曲马多缓释片镇痛,50~100 mg/次,6~8 h1次,每日总量不超过400 mg。观察两组患者术后镇痛效果及血糖水平的变化。结果观察组术后12、24、48 h的VAS评分均低于对照组（P〈0.05）;观察组术后12、24、48 h的血糖水平均低于对照组（P〈0.05）。结论芬太尼自控镇痛泵用于糖尿病术后镇痛的疼痛应激反应更小,更利于血糖水平的稳定,降低手术风险,促进糖尿病患者安全度过围手术期。Objective To observe the effects on blood glucose levels in diabetic patients controlled intravenous analgesia with fentanyl in patients after surgery Methods select the patients underwent surgery in our hospital during January 2014 to December2014 and who meet the diagnostic criteria for type 2 diabetes,190 patients were randomly divided into a control group and observation group 95 cases,blood glucose control in both groups of patients 7-10 mmol/L,before proceeding with surgery ketone negative,are taking inhalation anesthesia way,patients return to the ward after waking preventive analgesia.Observation group fentanyl analgesia,fentanyl 1.5 mg diluted with saline to 150 mL,using controlled analgesic pump by 2 mL/h constant rate infusion,and at any time to adjust the infusion rate according to patient pain assessment of the situation.The control group with oral tramadol hydrochloride sustained-release tablets analgesic,50-100 mg / time,six to eight hours a day,total does not exceed 400 mg.Observe the changes in postoperative analgesic effect and patient blood glucose levels.Results The postoperative VAS score 12,24,48 h were lower than the control group（P〈0.05）;observation group were 12,24,48 h glucose levels were lower than the control group（P〈0.05）.Conclusion Fentanyl controlled analgesia for postoperative analgesia pain diabetes stress smaller,more conducive to a stable blood sugar levels and reduce the risk of surgery,and promote diabetes patient safety through the perioperative period.

关 键 词：芬太尼 自控镇痛 糖尿病 术后 血糖水平 

分 类 号：R614[医药卫生—麻醉学]