皮下注射盐酸氢吗啡酮联合经静脉自控镇痛用于术后镇痛的安全性及效果分析  

Efficacy and safety analysis of hydromorphone hydrochloride combined with postoperative PCIA on postoperative analgesia

作　　者：陈素兰[1] 

机构地区：[1]广西医科大学第四附属医院麻醉科,广西柳州545005

出　　处：《海军医学杂志》2017年第3期238-241,共4页Journal of Navy Medicine

摘　　要：目的观察盐酸氢吗啡酮联合术后经静脉自控镇痛(PCIA)用于术后镇痛的安全性及效果。方法收集广西医科大学第四附属医院2016年4月1日至5月1日行全身麻醉术后要求镇痛患者80例,经知情同意后,采用数字表法随机分为A组(氢吗啡酮联合PCIA组)与B组(灭菌注射用水联合PCIA组),各40例。采取双盲法进行临床研究,记录麻醉复苏时间及麻醉复苏评分,麻醉复苏期间生命体征变化、拔管时间及术后2、4、6、8、24、48 h术后镇痛回访,记录视觉模拟评分(visual analogue scale,VAS)、Ramsay镇静评分、舒芬太尼用量及不良反应如恶心呕吐、眩晕、嗜睡、瘙痒、术后躁动、肌肉颤触、呼吸抑制等。结果与B组比较,A组麻醉复苏安静、镇痛效果满意,舒芬太尼用量为0μg,而B组65.6%的病例主诉有不同程度的疼痛,舒芬太尼用量(4.42±2.54)μg。A组术后2、4 h VAS评分低于B组,差异有统计学意义(P<0.05),2组病例24 h内发生恶心呕吐、眩晕、嗜睡、瘙痒、术后躁动、肌肉颤搐、呼吸抑制等不良反应发生率差异无统计学意义(P>0.05),2组均无呼吸抑制。结论皮下注射盐酸氢吗啡酮在有效作用时间内,可显著减轻麻醉复苏期间的疼痛,增加术后PCIA的镇痛效果,并且不增加术后PCIA的恶心呕吐、眩晕、嗜睡、瘙痒、躁动、肌肉颤搐、呼吸抑制及其他术后镇痛的不良反应发生率,安全性良好。Objective To investigate the safety and efficacy of hydromorphone hydrochloride combined with postoperative PCIA on postoperative analgesia. Methods A total of 80 patients who were admitted into the hospital for treatment and required post-operative analgesia after general anesthesia were recruited for the study and were randomly divided into group A （the hydromorphone hydrochloride combined with postoperative PCIA group） and group B （ the sterilizing injection combined with postoperative PCIA group） , each consisting of 40 patients. Double blind method was applied in the clinical research. Anesthesia recovery time and anes-thesia recovery scores, changes in vital signs during anesthesia recovery, tube extraction time, medial follow-ups 2,4, 6, 8 , 24 and 48 hours after postoperative analgesia, VAS scores, Ramsay sedation scores, sufentanil dosage and related adverse reactions （ nausea, vomiting, dizziness, drowsiness, itching, muscle twitch, postoperative agitation, respiratory depression, etc. ） were recorded and then comparisons were made with those of the controls. Results As compared with the patients of group B, the patients of group A were qui-et during postoperative analgesia and were satisfied with the analgesic effect. Sufentanil dosage for the patients of group A was 0 ug, while 65. 6% of the patients in group B with （4. 42 ±2. 54） ug dosage of sufentanil complained of different degrees of pain. Two and 4 hours after surgery, VAS scores of Group A were lower than those of group B, and statistical significance could be seen when compari-sons were made between them （P 〈 0. 05 ）. There were no significant differences in the incidence of adverse reactions （ nausea and vomiting, dizziness, drowsiness, itching, muscle twitch, postoperative agitation and respiratory depression） that occurred within 24 hours in the patients of the 2 groups and there were no cases of respiratory depression in the patients of the 2 groups （P 〉 0 . 0 5 ） .

关 键 词：盐酸氢吗啡酮 PCIA 麻醉复苏 全身麻醉术后镇痛 

分 类 号：R971[医药卫生—药品]