舒芬太尼与酒石酸布托啡诺在急诊与择期剖宫产患者的镇痛效果比较

发布时间：2018-04-14 10:26

本文选题：急诊手术 + 择期手术　；参考：《山东医药》2015年37期

【摘要】：目的探讨急诊与择期剖宫产的患者术后采用舒芬太尼及酒石酸布托啡诺自控静脉镇痛(PCIA)的效果及不良反应。方法择期与急诊剖宫产患者各60例,随机分成4组(n=30):择期手术分为C1组和C2组,急诊手术分为J1组和J2组,采用腰硬联合麻醉,术后均使用PCIA泵,C1和J1组配方采用酒石酸布托啡诺10 mg+地佐辛10 mg+托烷司琼6 mg,C2和J2组配方采用舒芬太尼100μg+地佐辛10 mg+托烷司琼6 mg,药物均用生理盐水稀释至100 m L。参数设定:负荷量2 m L,背景量2 m L/h,PCIA量0.5 m L,锁定时间15 min。观察并记录术后6(T1)、9(T2)、12(T3)、24(T4)、36(T5)、48 h(T6)各时间点的镇痛评分(VAS评分)和镇静评分(Rasmay评分),记录术后48 h内按压PCIA泵的次数和镇痛的不良反应。结果与J1组比较,C1组各时点VAS评分低;与J2组比较,C2组各时点VAS评分低(P均0.05)。与J1组比较,J2组T2、T3、T4时点VAS评分低、Rasmay评分高,与J2组比较,C2组Rasmay评分低(P均0.05)。J1组48 h内按压PCA泵次数高于J2、C1组(P均0.05)。J1组呕吐发生率高于C1组,J2组高于C2组(P均0.05)。结论急诊手术患者术后采取舒芬太尼镇静、镇痛效果较好;对于择期手术患者,酒石酸布托啡诺为较理想的选择。
[Abstract]:Objective to investigate the efficacy and side effects of sufentanil and butorphenol tartrate in patients undergoing caesarean section.Methods 60 cases of elective cesarean section and 60 cases of emergency caesarean section were randomly divided into 4 groups: group C1 and group C2. Emergency operation was divided into group J1 and group J2. Combined spinal-epidural anesthesia was used.After operation, the PCIA pump C1 and J1 groups were treated with butorphenol tartrate 10 mg dizocin 10 mg tropisetron 6 mg C 2 and J2 with sufentanil 100 渭 g dizocin 10 mg tropisetron 6 mg mg. The drugs were diluted to 100 mL with normal saline.Parameter setting: load 2 mL, background 2 mL / h, PCIA 0.5 mL, locking time 15 min.To observe and record the analgesic score and the sedation score of PCIA pump and the side effects of analgesia at every time point (6 ~ T _ 1 / 9 ~ 9 / T _ 2 / 12 T _ 3 / T _ 3 / 24 T _ 4 / T _ 4 ~ 36 ~ T _ 5 / T _ 6), and to record the number of times of pressing PCIA pump and the side effects of analgesia within 48 hours after operation.Results compared with J1 group, the VAS score of group C _ 1 was lower than that of group J _ 1, and the VAS score of group C _ 2 was lower than that of group J _ 2 (P < 0.05).Compared with J1 group, the VAS score was lower and Rasmay score was higher in J2 group than in J2 group. Compared with J2 group, the Rasmay score of 0.05).J1 group was lower than that of J2 group. The times of pressing PCA pump in P group were higher than that in J2C 1 group (P < 0.01). The incidence of vomiting in 0.05).J1 group was higher than that in C _ 1 group and C _ 2 group (P < 0.05).Conclusion Sufentanil is a good analgesic for patients undergoing emergency operation, and butorphenol tartrate is an ideal choice for patients undergoing elective operation.
【作者单位】：徐州医学院附属医院江苏省麻醉学重点实验室江苏省麻醉与镇痛应用技术重点实验室;徐州医学院附属医院;
【基金】：徐州医学院研究生科技创新课题(xyyc14-27)
【分类号】：R614

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