低剂量纳洛酮复合舒芬太尼用于胸椎手术患者术后静脉患者自控镇痛的效果  

Efficiency of intravenous patient-controlled analgesia with combined use of low-dose naloxone and sufentanil in patients underwent thoracic vertebral surgery

作　　者：丁明霞 沈卫红 胡义凤 DING Mingxia;SHEN Weihong;HU Yifeng(Department of Anesthesiology. Affilimed Wuxi Second Hospital,Nanjing Medical University,Wuxi 214002,CHINA)

机构地区：[1]南京医科大学附属无锡第二医院麻醉科

出　　处：《江苏医药》2019年第5期464-465,469,共3页Jiangsu Medical Journal

摘　　要：目的观察低剂量纳洛酮复合舒芬太尼静脉患者自控镇痛(PCA)用于胸椎融合减压内固定术的术后镇痛效果。方法 40例行胸椎融合减压内固定术患者随机均分为两组。PCA配方:N组为舒芬太尼2μg/kg+纳洛酮20μg+昂丹司琼6 mg;C组为舒芬太尼2μg/kg+昂丹司琼6 mg,两组均用生理盐水稀释至100 ml。背景剂量2 ml/h,单次PCA剂量1.5 ml,锁定时间15 min,术后镇痛48 h。观察两组术后6、12、24和48 h的VAS疼痛评分,记录PCA按压次数及术后不良反应的发生情况。结果 N组各时间点的VAS疼痛评分和术后不良反应发生率均低于C组(P<0.05或P<0.01),PCA泵按压次数也少于C组(P<0.01)。结论胸椎融合减压内固定术患者使用低剂量纳洛酮复合舒芬太尼静脉PCA的术后镇痛效果优于舒芬太尼单用,不良反应少。Objective To observe the efficiency of intravenous patient-controlled analgesia(PCA) with combined use of low-dose naloxone and sufentanil in the patients underwent thoracic vertebral surgery.Methods The intravenous PCA was performed for 48 hours after operation in 40 patients underwent thoracic vertebral fusion decompression and internal fixation,who were randomly divided into two groups with 20 cases each.The analgesic solution in group N consisted of sufentanil 2 μg/kg,naloxone 20 μg and ondansetron 6 mg,which in group C consisted of sufentanil 2 μg/kg+ondansetron 6 mg.The drugs were diluted to 100 ml with normal saline.The analgesic variables were set up as a background infusion of 2 ml/h and a bolus dose of 1.5 ml in a lockout interval of 15 minutes.The VAS pain scores at 6,12,24 and 48 hours after operation were evaluated.The PCA numbers and postoperative adverse responses were recorded.Results The VAS pain score at each time point and the incidence of postoperative adverse responses in group N were lower than those in group C(P<0.05 orP<0.01).The PCA number in group N was less than that in group C(P<0.01).Conclusion The efficiency of intravenous PCA with combined use of low-dose naloxone and sufentanil is better than sufentanil alone with less adverse responses in the patients underwent thoracic vertebral surgery.

关 键 词：纳洛酮 舒芬太尼 静脉患者自控镇痛 

分 类 号：R614[医药卫生—麻醉学]