舒芬太尼和曲马朵静脉自控镇痛不良反应的原因分析  

Analysis on reasons of adverse reactions in sufentanil and tramadol patient-controlled intravenous analgesia

作　　者：包代琴[1] 聂智容[1] 陈翠英[1] 甘晓琴[1] 葛衡江[1] 

机构地区：[1]第三军医大学大坪医院麻醉科,重庆400042

出　　处：《现代医药卫生》2016年第15期2301-2303,共3页Journal of Modern Medicine & Health

摘　　要：目的：分析舒芬太尼和曲马朵在静脉自控镇痛（PCIA）中引发的不良反应并采取措施进行改进，以提高镇痛效果及镇痛满意度。方法将2014年1~12月择期手术后采用舒芬太尼和曲马朵进行PCIA治疗的13077例患者作为对照组，另将2015年1~6月择期手术后采用舒芬太尼和曲马朵进行PCIA治疗的8142例患者作为观察组。观察组采取预防性用药、常规吸氧、密切观察患者生命体征、加强医护人员对麻醉药的认识等措施。观察两组疼痛评分和镇痛评分，以及不良反应（恶心呕吐、头昏嗜睡、低血压、呼吸抑制、皮肤瘙痒）发生情况。结果观察组镇痛有效率（97.80%）显著高于对照组（94.46%），镇痛满意度（84.81%）显著高于对照组（74.12%），差异均有统计学意义（P＜0.01）。观察组恶心、呕吐发生率明显低于对照组，皮肤瘙痒发生率、呼吸抑制发生率明显高于对照组，差异均有统计学意义（P＜0.05或0.01）。结论掌握镇痛不良反应的发生原因，并采取积极措施进行改进，能减轻手术给患者带来的痛苦，同时避免或减少术后镇痛不良反应的发生。Objective To analyze the adverse reactions caused by sufentanil and tramadol patient-controlled intra ve nous analgesia（PCIA） and to adopt the measures for conducting the improvement and increasing the analgesic effect and analgesic satisfaction. Methods A total of 13 077 patients adopting sufentanil and tramadol PCIA after elective operation from January to December 2014 were selected as the control group ,and 8 142 patients undergoing sufentanil and tramadol PCIA after elective op-eration from January to June 2015 were taken as the observation group. The observation group adopted the measures such as pre-ventive medication,routine oxygen inhalation,close observation of vital signs and strengthening the medical staff′s cognition on narcotic drugs. The pain score and sedation score,and occurrence situation of adverse reactions including nausea,vomiting,dizziness, drowsiness,hypotension,breath suppression and skin itching were observed in the two groups. Results The analgesic effective rate in the observation group was 97.80%,which was significantly higher than 94.46%in the control group,the sedation satisfac-tion rate in the observation group was 84.81%,which was significantly higher than 74.15%in the control group ,the differences were statistically significant（P〈0.01）. The incidence rate of nausea and vomiting in the observation group was lower than that in the control group,while the incidence rate of skin itching and breath suppression in the observation group was significantly higher than that in control group,the differences were statistically significant（P〈0.05 or 0.01）. Conclusion Mastering the causes of adverse reaction occurrence and adopting active measures to improve can alleviate the operation caused pain ,meanwhile avoid or reduce the occurrence of postoperative analgesia adverse reactions.

关 键 词：镇痛 静脉 手术后期间 疼痛 舒芬太尼 曲马朵 

分 类 号：R614[医药卫生—麻醉学]