羟考酮复合氟比洛芬酯用于胸科手术后静脉镇痛的疗效观察  

Effect observation of oxycodone combined with flurbiprofen on postoperative intravenous analgesia in patients with thoracic surgery

作　　者：尚宇 祝丽 龙晓宏 

机构地区：[1]解放军第四六三医院麻醉科,辽宁沈阳110042

出　　处：《实用临床医药杂志》2016年第15期39-42,共4页Journal of Clinical Medicine in Practice

摘　　要：目的探讨羟考酮复合氟比洛芬酯用于开胸手术后患者行自控静脉镇痛(PCIA)的临床效果。方法选择行择期开胸手术患者60例,随机分为2组。A组给予舒芬太尼+托烷司琼;B组给予羟考酮注射液+氟比洛芬酯+托烷司琼。记录术后4、12、24、48 h的血压(Bp)、心率(HR)、呼吸频率(RR)及疼痛、镇静评分,记录PCA泵按压次数和不良反应发生率。结果2组术后各时点MAP、HR、静息状态疼痛评分(R-VAS)差异无统计学意义(P>0.05);B组移动状态疼痛评分(咳嗽、体位改变,M-VAS)显著低于A组(P<0.05);A组48 h内PCA泵按压次数显著多于B组(P<0.05);B组术后各时点Ramsay镇静评分显著优于A组(P<0.05);B组患者术后恶心、呕吐和呼吸抑制发生率显著低于A组(P<0.05或0.01)。结论羟考酮复合氟比洛芬酯行多模式镇痛用于开胸手术后镇痛效果确切、安全,不良反应发生率低。Objective To explore the clinical effect of oxycodone combined with flurbiprofen on patient-controlled intravenous analgesia （PCIA） in patients with thoracic surgery. Methods Sixty patients were randomly divided into two groups. Group A was treated with sufentani and tropisetron, and group B was treated with oxyeodone, flurbiprofen and tropisetron. BP, HR, RR at 4, 12, 24, 48 hours after operation were recorded. Pains, sedation score, the times of PCA pump and incidence rate of adverse reactions were compared. Results There were no significant differences in MAP, HR, R- VAS between two groups in postoperative time points （P 〉 0.05）. Scores of cough, postural changes and MWAS in group B were significantly lower than those in group A （ P 〈 0.05 ）. In group A, press- ing times of PCA pump within 48 h was significantly more than group B （ P 〈 0.05 ）. Ramsay Sedation score at each time points in group B was significantly higher than that in group A （ P 〈 0.05 ）. Inci- dence rates of nausea, vomiting and respiratory inhibition in group B were significantly lower than those in group A （P 〈 0.05 or P 〈 0.01 ）. Conclusion Oxycodone combined with flurbiprofen is effective and safe for PCIA in patients with thoracic surgery, and incidence rate of adverse reactions is low.

关 键 词：羟考酮 舒芬太尼 氟比洛芬酯 多模式镇痛 患者自控静脉镇痛 

分 类 号：R614[医药卫生—麻醉学]