阿片类药物硬膜外术后镇痛对剖宫产患者胃肠运动功能的影响

发布时间：2018-02-10 00:02

本文关键词： 吗啡舒芬太尼芬太尼剖宫产硬膜外镇痛胃肠运动　出处：《皖南医学院》2015年硕士论文　论文类型：学位论文

【摘要】：目的:研究比较吗啡、芬太尼、舒芬太尼三种阿片类药物硬膜外术后镇痛对剖宫产患者术后胃肠运动功能的影响,并观察术后恶心呕吐(PONV)发生率及镇痛效果。方法:选择剖宫产手术患者80例,根据硬膜外术后镇痛与否及所用镇痛药物的不同,分成4组(每组20例):M组:吗啡40ug"mL;S组:舒芬太尼0.4ug"mL;F组:芬太尼4ug"mL;C组:患者拒绝使用镇痛泵。观察记录各组患者术后肠蠕动恢复时间和肛门第一次排气时间,术后恶心呕吐发生率,术后即刻、3h、12h、24h、48h的VAS评分。结果:1.胃肠运动功能:(1)与其它三组比较,M组术后肠蠕动恢复时间和肛门第一次排气时间均明显延长(P0.05)。(2)M、F、S组胃肠运动功能恢复的时间明显长于C组(P0.05)。(3)S组胃肠运动功能恢复的时间明显快于M组和F组(P0.05)。2.恶心呕吐:(1)M、F、S组术后恶心呕吐发生率明显高于C组(P0.05)。(2)M组术后恶心呕吐发生率明显高于其它组(P0.05)。(3)F、S组术后恶心呕吐发生率两组之间比较无统计学差异(P0.05)。3.VAS评分:(1)与其它三组比较,C组术后3hVAS评分高(P0.05)。(2)四组患者术后12hVAS评分相较之前均明显升高(P0.05)。(3)C组患者术后12h至24hVAS评分波动于5-6。结论:与吗啡和芬太尼相比,舒芬太尼能在保证良好镇痛的基础上,对硬膜外术后镇痛的剖宫产患者胃肠运动功能抑制最小。
[Abstract]:Objective: to compare the effects of epidural analgesia with morphine, fentanyl and sufentanil on gastrointestinal motility after cesarean section. The incidence and analgesic effect of postoperative nausea and vomiting were observed. Methods: 80 patients with cesarean section were selected according to the analgesia after epidural operation or not and the analgesic drugs used. The patients were divided into 4 groups (20 cases in each group: morphine 40ug "mLL group: sufentanil 0.4ug" mLF group: fentanyl 4ug "mLnL group C): patients refused to use analgesic pump. The recovery time of intestinal peristalsis and the first exsufflation time of anus were observed and recorded in each group. Postoperative nausea and vomiting, VAS score of 24 h and 48 h after operation. Results compared with the other three groups, the recovery time of intestinal peristalsis and the first exhaust time of anus in group M were significantly longer than those in group FS. The recovery time of gastrointestinal motor function in group C was significantly faster than that in group M and group F. the incidence of postoperative nausea and vomiting in group C was significantly higher than that in group C (P 0.05). There was no significant difference in the incidence of vomiting between the two groups. 3. The VAS score in group C was significantly higher than that in group C at 3 hours after operation (P 0.05) and the VAS score in group C was significantly higher than that in group C at 12 hours after operation. The VAS scores in group C were significantly higher than those in group C at 12 hours to 24 hours after operation, and the VAS scores fluctuated from 5 to 6 hours after operation. Conclusion: compared with morphine and fentanyl, Sufentanil, on the basis of good analgesia, minimized the inhibition of gastrointestinal motility in patients undergoing epidural analgesia.
【学位授予单位】：皖南医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R614

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