不同剂量舒芬太尼自控静脉镇痛对剖宫产患者术后恢复的影响  

Effects of different doses of sufentanil patient-controlled intravenous analgesia on postoperative recovery in patients undergoing cesarean section

作　　者：许秀艺 黄惠琼 XU Xiu-yi;HUANG Hui-qiong(Department of Anesthesiology,Department of Obstetrics and Gynecology,Women and Children's Hospital,School of Medicine,Xiamen University/Xiamen Maternal and Child Health Hospital,Xiamen 361002,Fujian Province,China)

机构地区：[1]厦门大学附属妇女儿童医院/厦门市妇幼保健院妇产科学系麻醉科,福建厦门361002

出　　处：《中国临床药理学杂志》2024年第24期3538-3542,共5页The Chinese Journal of Clinical Pharmacology

摘　　要：目的观察不同剂量舒芬太尼注射液自控静脉镇痛(PCIA)对剖宫产(CS)患者术后恢复的影响。方法将入组CS患者随机分为对照组与试验组。对照组用0.04μg·kg^(-1)·h^(-1)枸橼酸舒芬太尼注射液+地佐辛注射液15 mg+盐酸昂丹司琼注射液8 mg进行PCIA;试验组用0.07μg·kg^(-1)·h^(-1)枸橼酸舒芬太尼注射液+地佐辛注射液15 mg+盐酸昂丹司琼注射液8 mg进行PCIA。比较2组患者的数字评估量表(NRS)评分、镇痛泵按压次数、Ramsay镇静评分、恢复质量量表(QoR-40)评分,监测患者血流动力学情况,并进行安全性评价。结果对照组入组58例,脱落6例,最终纳入52例进行统计分析;试验组入组58例,脱落2例,最终纳入56例进行统计分析。术后48 h,对照组和试验组静息状态NRS评分分别为1.00(1.00,1.00)和1.00(0.00,1.00)分;活动状态NRS评分分别为1.00(1.00,2.00)和1.00(0.00,0.00)分;镇痛泵按压次数分别为18.00(16.00,19.00)和3.00(3.00,4.00)分;QoR-40总分分别为(169.50±7.19)和(186.77±4.95)分,上述指标组间比较,在统计学上差异均有统计学意义(均P<0.05)。术后48 h,对照组和试验组Ramsay镇静评分分别为2.00(2.00,2.00)和2.00(2.00,2.00)分;心率分别为(80.08±5.14)和(79.16±5.32)beat·min^(-1);平均动脉压分别为(82.21±9.06)和(82.33±8.49)mmHg,上述指标组间比较,在统计学上差异均无统计学意义(均P>0.05)。对照组发生的药物不良反应主要有恶心呕吐、头晕和皮肤瘙痒等,试验组发生的药物不良反应主要有皮肤瘙痒和嗜睡等。对照组和试验组药物不良反应的总发生率分别为71.15%和58.93%,在统计学上差异无统计学意义(P>0.05)。结论高浓度舒芬太尼(0.07μg·kg^(-1)·h^(-1))与低浓度舒芬太尼(0.04μg·kg^(-1)·h^(-1))PCIA方案相比,药物用量更加合理,不会引起过度镇静、不增加药物不良反应发生率,具有更好的镇痛效果,有利于患者恢复。Objective To observe the effect of different doses of sufentanil citrate injection patient-controlled intravenous analgesia(PCIA)on postoperative recovery in patients undergoing caesarean section(CS).Methods The enrolled CS patients were randomly divided into control group and treatment group.The control group underwent PCIA with0.04μg·kg^(-1)·h^(-1)sufentanil citrate injection+dezocine injection15 mg+ondansetron hydrochloride injection 8 mg;the treatment group was treated with 0.07μg·kg^(-1)·h^(-1)sufentanil citrate injection+dezocine injection 15 mg+ondansetron hydrochloride injection 8 mg for PCIA.The numerical rating score(NRS),the number of analgesic pump compressions,the Ramsay sedation score,the Quality of Recovery-40(QoR-40)score,hemodynamic paramecers,and safety evaluation compared between the two groups,the hemodynamic conditions of the patients were monitored,and the safety was evaluated.Results In the control group,58 cases were enrolled and 6 cases were dislodged,and 52 cases were finally included for statistical analysis;in the treatment group,58 cases were enrolled and 2 cases were dislodged,and 56 cases were finally included for statistical analysis.At 48 h after surgery,the resting state NRS in control group and treatment group were 1.00(1.00,1.00)and 1.00(0.00,1.00)scores;the activity state NRS were 1.00(1.00,2.00)and 1.00(0.00,1.00)scores;the number of analgesic pump compressions were 18.00(16.00,19.00)and 3.00(3.00,4.00)scores;the total QoR-40 score were(169.50±7.19)and(186.77±4.95)scores;there were statistically significant differences between the two groups(P<0.05).At 48 h after operation,the Ramsay sedation scores in the control group and the treatment group were 2.00(2.00,2.00)and 2.00(2.00,2.00)times,respectively;the heart rates were(80.08±5.14)and(79.16±5.32)beat·min^(-1),respectively;the mean arterial pressures were(82.21±9.06)and(82.33±8.49)mmHg,respectively.These difference were not statistically significant(P>0.05).The adverse drug reactions of treatment group were nause

关 键 词：枸橼酸舒芬太尼注射液 剖宫产 患者自控静脉镇痛 

分 类 号：R971.2[医药卫生—药品]