芬太尼和硫酸镁对布比卡因蛛网膜下腔阻滞的影响  

Effect of fentanyl and magnesium sulfate on bupivacaine induced subarachnoid block

作　　者：汪辉德[1] 翁艳[1] 钟庆[1] 张卫[1] 周睦川 郭秀琼[1] 杨国仁[1] Wang Huide Weng Yan Zhong Qing Zhang Wei Zhou Muchuan Guo Xiuqiong Yang Guoren(Department of A nesthesialogy and Pain, Jianyang Municipal People＇s Hospital, Sichuan 641400, China)

机构地区：[1]简阳市人民医院麻醉疼痛科,四川641400

出　　处：《现代医药卫生》2017年第15期2270-2272,共3页Journal of Modern Medicine & Health

摘　　要：目的探讨布比卡因蛛网膜下腔阻滞时辅助使用芬太尼和不同剂量硫酸镁对其麻醉效果的影响。方法选取2013年1月至2015年12月该院收治的择期在蛛网膜下腔麻醉下行脐平面以下手术患者100例作为研究对象,将其分为C组(对照组)、F组(芬太尼组)、M_1组(硫酸镁1组)、M_2组(硫酸镁2组),各25例。记录各组患者一般情况、手术时间,给药后5、10、15、20 min的心率(HR)、平均动脉压(MAP)和阻滞节段;记录患者镇痛时间和完全恢复时间,记录术后使用镇痛药及发生嗜睡或瘙痒情况。结果给药后5、10、15、20 min,F、M_1、M_2组HR和MAP,以及C组MAP均较基础值降低,差异均有统计学意义(P<0.05);给药后15、20 min,C组HR较基础值降低,差异有统计学意义(P<0.05)。给药20 min后,M_1、M_2组患者在T_(11)阻滞平面的人数多于C、F组,差异均有统计学意义(P<0.05)。C组患者镇痛时间、麻醉完全恢复时间均短于F、M_1组,差异均有统计学意义(P<0.05)。所有患者均未出现嗜睡或瘙痒等不良反应。结论使用硫酸镁或芬太尼作为布比卡因蛛网膜下腔麻醉的辅助用药,能延长镇痛时间,减少术后镇痛药物的需求,无术后不良反应。Objective To investigate the influence of auxiliary use of fentanyl and different doses of magnesium sulfate on the anesthesia effect in bupivacaine subarachnoid block. Methods One hundred patients with elective infra-umbilical surgeries under subarachnoid space anesthesia in our hospital from January 2013 to December 2015 were selected as the research sub-jects and divided into the group C（control group）,F（fentanyl group）,M_1 group（magnesium sulfate 1 group） and M_2 group（magnesium sulfate 2 group）,25 cases in each group. The general condition,operation time,heart rate（HR）,MAP and block segments at 5,10,15,20 min after medication were recorded. The analgesic time and complete recovery time were recorded. The postopera-tive analgesic drugs, drowsiness or pruritus occurrence were recorded. Results HR and MAP at 5,10,15,20 min after medication in the group F,M_1 and M_2,and MAP in the group C were decreased compared with the base values,the differences were statistically significant（P〈0.05）. HR at 15, 20 min after medication in the group C was decreased compared with the base value,the differences were statistically significant（P〈0.05）. The cases at T_（11） block plane at 20 min after medication in the group M_1 and M_2 were more than those in the group C and F, the difference was statistically significant（P〈0.05）. The analgesic time and anesthetic complete recovery time in the group C were shorter than those in the group F and M_1,the differences were statistically significant（P〈0.05）. All cases did not appear the adverse reactions such as drowsiness or pruritus. Conclusions Using magnesium sulfate and fentanyl as auxiliary drugs of bupivacaine subarachnoid space anesthesia can extend the analgesic time,reduces the need of postoperative analgesic drugs without increasing postoperative adverse reactions.

关 键 词：蛛网膜下腔 麻醉药 局部 镇痛药 硫酸镁 

分 类 号：R614.4[医药卫生—麻醉学]