盐酸氢吗啡酮用于臂丛麻醉再植术后自控静脉镇痛的临床研究  

Clinical study on the effect of patient-controlled intravenous analgesia with Hydromorphone hydrochloride for brachial plexus anesthesia in finger replantation

作　　者：古汉南 古小玲 万花平 陈瑶 王金玲 张子清 

机构地区：[1]深圳市龙岗区骨科医院,广东深圳518116

出　　处：《中国当代医药》2017年第26期102-104,共3页China Modern Medicine

基　　金：广东省深圳市科技计划项目(JCYJ20160429104231738);广东省深圳市龙岗区科技创新计划项目(201505153001004)

摘　　要：目的探究臂丛麻醉再植手术后使用盐酸氢吗啡酮复合甲磺酸罗哌卡因的镇痛疗效与副作用。方法选取我院2013年2月~2015年2月上肢再植患者68例作为研究对象,将所有患者随机分成观察组与对照组,各34例。观察组使用的药物和剂量为2 mg盐酸氢吗啡酮+160 mg甲磺酸罗哌卡因+5 mg托烷司琼;对照组使用药物为0.125 mg舒芬太尼+160 mg甲磺酸罗哌卡因+5 mg托烷司琼。开始时背景输注2 ml/h,每次自控剂量为0.5 ml,在15 min内进行锁定。手术结束后两组都将提前配备好的5 ml镇痛液进行加注,手术完毕后4、8、12、24、48 h内对患者镇痛、镇静效果进行评估,同时对不良反应做仔细观察与记录。结果观察组患者VAS评分低于对照组,镇静评分低于对照组,恶心、呕吐发生率低于对照组,差异有统计学意义(P<0.05)。两组患者头晕、皮肤瘙痒及呼吸困难发生率比较,差异无统计学意义(P>0.05)。结论臂丛麻醉再植移植手术后可使用盐酸氢吗啡酮进行镇痛,不良反应发生率明显降低,术后镇痛效果佳。Objective To study the analgesic effect and side effects of Hydromorphone hydrochloride combined with Ropivacaine Mesylate after brachial plexus anesthesia in finger replantation.Methods A total of 68 cases of arm replantation patients in our hospital from February 2013 to February 2015 were selected as the research objects were divided into the observation group and the control group according to the random number table method,with 34 cases in each group.The observation group were given drugs and doses as following：2 mg hydromorphone hydrochloride＋160 mg Ropivacaine Mesylate ＋5 mg Tropisetron;the control group：0.125 mg Sufentanil ＋160 mg Ropivacaine Mesylate ＋5 mg Tropisetron.The background infusion speed was 2 ml/h,and each time the control dose was 0.5 ml which is locked within 15 min.After surgery two groups were equipped with 5 ml analgesic liquid.After 4,8,12,24,48 h,the score of VAS and sedation were compared between two groups,and the side effects of analgesia,function scoring were recorded.Results The score of VAS and sedation and the incidence of nausea and vomiting in the observation group were lower than those in the control group,and the differences were statistically significant（P〈0.05）.There were no significant differences in the incidence of swirl,cutaneous pruritus and dyspnea between two groups（P〉0.05）.Conclusion Hydromorphone hydrochloride for analgesia after brachial plexus anesthesia can significantly reduce the incidence of adverse reactions, and can effectively relieve postoperative pain.

关 键 词：盐酸氢吗啡酮 舒芬太尼 臂丛麻醉 静脉自控镇痛 

分 类 号：R614.4[医药卫生—麻醉学]