盐酸羟考酮联合帕瑞昔布钠对瑞芬太尼复合麻醉患者手术后痛觉过敏的影响

发布时间：2018-01-19 03:21

本文关键词： 羟考酮盐酸帕瑞昔布钠瑞芬太尼痛觉过敏　出处：《医药导报》2016年09期 　论文类型：期刊论文

【摘要】：目的观察盐酸羟考酮联合帕瑞昔布钠对瑞芬太尼复合麻醉患者手术后痛觉过敏的影响及安全性。方法择期行腹腔镜子宫肌瘤剥除手术患者88例,随机分为对照组、盐酸羟考酮组、帕瑞昔布钠组和联合组,各22例,分别在手术结束前30 min静脉注射0.9%氯化钠溶液10 m L,盐酸羟考酮0.1 mg·kg-1,帕瑞昔布钠40 mg和盐酸羟考酮0.1 mg·kg-1联合帕瑞昔布钠40 mg。观察并记录手术后30 min,1,2,4,8 h的视觉模拟评分(VAS),同时记录各组手术后躁动、寒战、恶心呕吐和24 h内追加镇痛药物的例数。结果与对照组比较,盐酸羟考酮组、帕瑞昔布钠组和联合组手术后各时点VAS评分均明显降低(均P0.05),联合组手术后各时点VAS评分均明显低于盐酸羟考酮组和帕瑞昔布钠组(均P0.05)。联合组手术后躁动和寒战发生率分别为0.0%,5.0%,均明显低于对照组(45.0%,23.0%)(P0.05);联合组手术后无镇痛药追加患者,对照组、盐酸羟考酮组和帕瑞昔布钠组镇痛药追加患者分别有12,5,5例(P0.05)。结论盐酸羟考酮联合帕瑞昔布钠能有效减轻瑞芬太尼复合麻醉患者手术后痛觉过敏,降低手术后躁动的发生率。
[Abstract]:Objective to observe the effect and safety of hydroxycodone hydrochloride combined with paroxib sodium on postoperative hyperalgesia in patients with remifentanil combined anesthesia. They were randomly divided into three groups: control group (n = 22), control group (n = 22), paroxib sodium group (n = 22) and combined group (n = 22). 0.9% sodium chloride solution was injected intravenously 30 min before the end of operation. Hydroxycodone hydrochloride 0.1 mg 路kg-1. 40 mg of paroxib sodium and 0.1 mg 路kg-1 of hydroxycodone hydrochloride combined with 40 mg of paroxib sodium were observed and recorded 30 minutes after operation. Visual analogue score (VAS) for 8 h was used to record the cases of restlessness, shivering, nausea and vomiting, and the addition of analgesic drugs within 24 hours after operation in each group. Results compared with the control group, the control group was treated with hydroxycodone hydrochloride. The VAS scores were significantly decreased at each time point after operation in both the paroxib sodium group and the combined group (all P 0.05). The VAS scores in the combined group were significantly lower than those in the hydroxycodone hydrochloride group and the paroxib sodium group (P 0.05). The incidence of restlessness and shivering was 5.0% in the combined group. All of them were significantly lower than that of the control group (45.0%, 23.0%, P 0.05%). In the combined group, there were 12 cases in the control group, hydroxycodone hydrochloride group and pareoxib sodium group respectively. Conclusion Hydrocodone hydrochloride combined with paroxib sodium can effectively reduce postoperative hyperalgesia and reduce the incidence of restlessness in patients with remifentanil combined anesthesia.
【作者单位】：新疆维吾尔自治区人民医院麻醉科;
【分类号】：R614
【正文快照】： 瑞芬太尼具有镇痛作用强、代谢不依赖肝肾功能、持续时间短、临床应用无蓄积等优点,因此得到广泛应用。但其分布与消除半衰期短,停药后镇痛作用迅速消失,常引起手术后痛觉过敏[1]。临床研究表明,帕瑞昔布钠能有效减轻瑞芬太尼复合全麻后引起的痛觉过敏[2],但其效果亟待进一步

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