舒芬太尼复合曲马多用于剖宫产术后镇痛的临床观察  

Clinical observation on the effect of sufentanil combined with tramadol on postcesarean analgesia

作　　者：郑华[1] 陈晔凌[1] 张咸伟[1] 田玉科[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院麻醉科,湖北武汉430030

出　　处：《中国妇幼保健》2015年第35期6363-6365,共3页Maternal and Child Health Care of China

基　　金：湖北省自然科学基金项目〔2014CFB293〕;湖北省卫生和计划生育委员会科研项目〔WJ2015MB059〕;同济医院科研基金项目〔2013A006〕

摘　　要：目的回顾性分析舒芬太尼复合曲马多在剖宫产术后镇痛中应用的有效性和安全性,并探讨其用药剂量的影响因素。方法选取从2013年4月-2015年4月行剖宫产术,术后接受24 h舒芬太尼(1μg/ml)复合曲马多(1.4 mg/ml)自控静脉镇痛的患者。术后镇痛期间,记录患者静止和活动疼痛评分、镇静评分、心率、血压、脉搏氧饱和度、用药剂量、不良反应以及满意度。结果共有4 637例患者纳入分析。术后各个时点患者静止VAS疼痛评分为(13.97±10.23),活动VAS疼痛评分(20.24±11.81),Ramsay评分为2(2,2),心率(80±18)次/min,收缩压(117±25)mm Hg,舒张压(66±12)mm Hg,脉搏氧饱和度(97±3)%,对术后镇痛的满意度为5(4,5)。术后镇痛不良反应中,恶心呕吐的发生率最高(2.70%),其次是眩晕(0.99%)和腹胀(0.24%)。此外,研究期间无术后镇痛相关的死亡。患者麻醉方式显著影响术后镇痛用药量,年龄、体重、身高、体重指数对术后镇痛用药量的影响无统计学意义。结论舒芬太尼复合曲马多用于剖宫产术后患者自控静脉镇痛效果确切、不良反应发生率低、患者满意度高,其具体用药剂量受麻醉方式等因素的影响。Objective To retrospectively analyze the efficacy and safety of sufentanil combined with tramadol for postoperative an- algesia, explore the influencing factors of doses. Methods The patients undergoing cesarean section and postoperative patient-controlled in-travenous analgesia （PCIA） with sufentanil （ 1 μg/ml） combined with tramadol （ 1.4 mg/ml） within 24 hours from April 2013 to April 2015 were selected, the pain scores at rest and during movement, sedation score, heart rate, blood pressure, oxygen saturation, total analgesia consumption, adverse reactions, and satisfaction during PCIA were recorded. Results VAS scores at rest and during movement after cesarean section were （ 13.97±10. 23） and （20. 24±11.81 ） points; Ramsay score was 2 （2, 2） ; heart rate was （80±18） times per minute; sys- tolic blood pressure and diastolic blood pressure were （117±25 ） mmHg and （66±12） mmHg, respectively; pulse oxygen saturation was （97±3）% ; the satisfaction with postoperative analgesia was 5 （4, 5） . Among adverse reactions after cesarean section, the incidence rate of nausea and vomiting was the highest （2. 70% ）, followed by dizziness （0, 99% ） and abdominal distension （0. 24% ） . In addition, no PCIA-related death occurred. Anesthetic types significantly affected the doses of analgesic drugs ; age, weight, height, and body mass index （BMI） had no statistically significantly impact on the doses of analgesic drugs. Conclusion The analgesic effect of sufentanil combined with tramadol for postoperative analgesia is significant, the incidence rate of adverse reactions is low, the satisfaction rate is high, the doses of analgesic drugs are affected by anesthetic types.

关 键 词：舒芬太尼 曲马多 术后镇痛 患者自控镇痛 剖宫产术 

分 类 号：R719[医药卫生—妇产科学]