不同舒芬太尼配置浓度对术后患者静脉自控镇痛效果和不良反应的影响

发布时间：2019-02-16 03:00

【摘要】：目的比较不同配置浓度的舒芬太尼对术后患者静脉自控镇痛(PCA)效果和不良反应的影响。方法回顾性分析2004年1月至2016年12月在北京协和医院收治的6231例择期全身麻醉术后使用舒芬太尼静脉PCA患者的临床资料,根据舒芬太尼配置浓度不同分为0.4μg/ml(SF4,n=1421)、0.6μg/ml(SF6,n=2489)、0.8μg/ml(SF8,n=1326)和1.0μg/ml(SF10,n=995)4组,比较4组间术后48 h内舒芬太尼用药总量、镇痛效果和不良反应的差异。结果4组患者的舒芬太尼术后48 h内药物用量总体积数(χ~2=87.316,P0.001)和用药总量(χ~2=20.261,P0.001)差异有统计学意义。4组患者术后第1天和第2天的静息以及运动VAS评分差异均无统计学意义(P均0.05)。4组患者术后第1天的镇静程度评分差异有统计学意义(χ~2=9.042,P=0.029)。4组患者术后第1天(χ~2=7.855,P=0.012)和术后第2天(χ~2=5.635,P=0.044)的未排气发生率差异有统计学意义。其他不良反应各组间差异均无统计学意义(P均0.05)。结论在全身麻醉术后使用舒芬太尼静脉PCA的患者中,较高的舒芬太尼配置浓度可能在不改善患者术后48 h镇痛效果的前提下提高镇静、肠道未排气等不良反应的发生率。
[Abstract]:Objective to compare the effects and side effects of sufentanil in different concentrations on postoperative patient-controlled analgesia (PCA). Methods the clinical data of 6231 patients treated with sufentanil intravenous PCA after elective general anesthesia from January 2004 to December 2016 in Peking Union Hospital were retrospectively analyzed. According to the different concentrations of sufentanil, they were divided into 0.4 渭 g/ml (SF4,). Four groups, 0.6 渭 g/ml (SF6,n=2489), 0.8 渭 g/ml (SF8,n=1326) and 1.0 渭 g/ml (SF10,n=995), were used to compare the total amount of sufentanil, analgesic effect and side effects within 48 hours after operation. Results the total volume of sufentanil and the total dosage of sufentanil within 48 hours after operation (蠂 ~ 2 + 87.316g / P0.001) and the total dosage of sufentanil (蠂 ~ 2) 20.261, respectively. There was no significant difference between the rest and exercise VAS scores on the 1st and 2nd day after operation (P0. 001). The sedation degree score of the 4 groups was poor on the 1st day after operation (P0. 05). The difference was statistically significant (蠂 ~ 2 ~ (9.042), P < 0.05). There was a significant difference in the incidence of non-exhaust between the 4 groups on the 1st day after operation (蠂 ~ 27.855) and on the second day after operation (蠂 ~ 2 ~ (5.635). There was no significant difference in other adverse reactions among groups (P 0.05). Conclusion in patients with sufentanil intravenous PCA after general anesthesia, the higher concentration of sufentanil may increase the incidence of sedation, intestinal non-exhaust and other adverse reactions without improving the analgesic effect 48 hours after operation.
【作者单位】：中国医学科学院北京协和医学院北京协和医院麻醉科;
【分类号】：R614

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