某院手术室注射用麻醉药品及第一类精神药品残余液的情况分析  

Analysis of the residual fluid of anesthesia for injection and class I psychotropic drugs in the operating room ofa hospital

作　　者：陈婧[1] 于阗[1] 陈华漫[1] CHEN Jing;YU Tian;CHEN Huaman(First Affiliated Hospital of Xiamen University,Xiamen 361022,China)

机构地区：[1]厦门大学附属第一医院,厦门361022

出　　处：《中国药物依赖性杂志》2022年第1期62-66,70,共6页Chinese Journal of Drug Dependence

摘　　要：目的分析某医院手术室注射用麻醉药品、第一类精神药品残余情况,以增强手术室麻醉、第一类精神药品的规范化管理。方法采用回顾性研究方法对该院手术室2020年7月—2020年12月注射用麻醉、第一类精神药品处方进行统计和分析。结果共收集28 651张注射用麻醉、第一类精神药品处方,其中残余量最多(残余量占比最高)的药品为盐酸麻黄碱注射液27 467.7mg(79.69%),其次为盐酸吗啡注射液454.5mg(69.92%)。而平均单次处方残余量占规格比(%)最高的药品为注射用盐酸瑞芬太尼(96.00%)、其次为盐酸麻黄碱注射液(80.03%)和盐酸吗啡注射液(72.10%);残余处方多集中在46岁以上年龄层次,但枸橼酸芬太尼2ml:0.1mg注射液静脉滴注集中在年龄≤12岁,占比28.61%;使用麻醉药品、第一类精神药品的手术以小儿包茎、子宫内膜息肉、子宫平滑肌瘤、甲状腺结节、急性腹膜炎5类手术处方最多,残余量也最大;不同科室中使用麻醉药品、第一类精神药品以肿瘤内科、泌尿外科、小儿生长发育专科、甲状腺专科、神经外科专科处方量最多,开具残余处方占比以小儿生长发育专科35.36%最高,而残余总量以神经外科专科53.15%最高。结论存在手术室注射用麻醉药品、第一类精神药品不同程度残余问题为规避流弊风险对残余量(残余量占比)较大的药品,如盐酸麻黄碱注射液和盐酸吗啡注射液,建议厂家增加较小规格品种、减少残余量;还需要对手术室内注射用麻醉药品、第一类精神药品的使用进一步完善精细化操作流程和残余液管理制度,确保麻醉药品、第一类精神药品的合理使用。Objective To analyze the residual situation of narcotic drugs for injection and psychotropic drugs of class I in the operating room of a hospital, and to strengthen the standardized management of narcotic drugs and psychotropic drugs of class I in the operating room. Methods A retrospective study was conducted to analyze the prescriptions of narcotic drugs for injection and class I psychotropic drugs in the hospital from July 2020 to December 2020. Results A total of 28 651 prescriptions of narcotic drugs for injection and psychotropic drugs of class I were collected. Among them, the drug with the highest residual amount(proportion of residual amount) was ephedrine hydrochloride injection(27467.7 mg, 79. 69%), followed by morphine hydrochloride injection(454.5 mg, 69.92%). Remifentanil hydrochloride for injection(96.00%) accounted for the highest proportion of average single prescription residue(%), followed by ephedrine hydrochloride injection(80.03%) and morphine hydrochloride injection(72.10%). Most of the residual prescriptions were over 46 years old. However, intravenous drip of fentanyl citrate 2 ml: 0.1 mg injection concentrated in patients aged ≤12 years old, accounting for 28.61%. Five kinds of operation prescriptions including pediatric phimosis, endometrial polyps, uterine leiomyoma, thyroid nodule and acute peritonitis were the most frequently used, and the residual amount was also the largest. Departments with the largest number of prescriptions of narcotic drugs and the psychotropic drugs of class I were the department of oncology, urology, pediatric growth and development, thyroid and neurosurgery. The proportion of residual prescriptions issued by children′s growth and development was the highest, accounting for 35.36%, while the highest proportion of the total amount of residual was in neurosurgery, accounting for 53.15%. Conclusion For the drugs with large residual amount(residual proportion), such as ephedrine hydrochloride injection and morphine hydrochloride injection, it is suggested tha

关 键 词：注射用麻醉药品 注射用第一类精神药品 残余液 手术室 合理应用 科学管理 

分 类 号：R749[医药卫生—神经病学与精神病学]