不同剂量舒芬太尼用于开腹手术后静脉自控镇痛的效果比较

发布时间：2018-02-23 21:30

本文关键词： 舒芬太尼静脉自控镇痛开腹手术　出处：《广西医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的：比较不同剂量舒芬太尼用于开腹手术术后静脉自控镇痛(PCIA)的效果,择出最佳剂量,为开腹手术病人术后PCIA用药提供参考。方法：将择期行开腹手术并要求行术后静脉自控镇痛的120例患者,随机分为4组(n=30)：A组、B组、C组、D组术后分别以1.5、2.0、2.5、3.0μg/kg舒芬太尼配制术后静脉自控镇痛用药,每组加入盐酸甲氧氯普胺注射液20mg,用0.9%氯化钠注射液稀释成150ml。镇痛泵参数设置：背景剂量3ml/h,PCA剂量3ml/次,负荷剂量为0ml,锁定时间20min。分别于术后6h (T1)、12h (T2)、24h(T3)、48h(T4)对患者进行回访,并进行痛疼评分、镇静评分等,记录患者各个时间点的生命体征及不良反应。结果：D组患者术后四个时点的PCIA镇痛效果明显优于A、B、C组(P0.05),而C组患者术后四个时点的PCIA镇痛效果明显优于A、B组(P0.05)。D组的PCA按压次数明显少于A、B、C组(P0.05),而C组的PCA按压次数则明显少于A、B组(P0.05)。然而,D组患者恶心呕吐评分和头晕的发生率明显高于其他3组(P0.05),而其他3组的不良反应无明显差异(P0.05)。4组患者术后四个时点的镇静评分和生命体征改变的比较,差异均无统计学意义(P0.05)。结论：舒芬太尼用于开腹手术后静脉自控镇痛的最适配药剂量为2.5μg/kg,即背景剂量为O.05μg/(kg·h), PCA剂量为0.05μg/(kg·次)
[Abstract]:Objective: to compare the effects of different doses of sufentanil for postoperative patient-controlled intravenous analgesia (PCIA) after laparotomy, and to select the best dose. Methods: one hundred and twenty patients who underwent open surgery and required postoperative patient-controlled intravenous analgesia were treated with PCIA. Four groups were randomly divided into 4 groups: group B, group B, group C and group D were treated with 2.5 渭 g / kg sufentanil, respectively, for postoperative patient-controlled analgesia. Each group was added 20 mg methoxyclopramide hydrochloride injection and diluted into 150 ml with 0.9% sodium chloride injection. The parameters of the analgesic pump were as follows: the background dose was 3 ml / h, the loading dose was 0 ml, the locking time was 20 min. The patients were visited at 6 h after operation. Pain score, sedation score, etc. Results the analgesic effect of PCIA at four time points in group D was significantly better than that in group C (P 0.05), but the analgesic effect of PCIA in group C was better than that in group A B (P 0.05). The times of PCA compression in group C were significantly less than those in group A (P 0.05), but the times of PCA compression in group C were significantly less than those in group A (B). However, the incidence of nausea and vomiting score and dizziness in group D was significantly higher than that in group A (P 0.05), but the adverse reactions in the other three groups were not obvious. Comparison of sedation scores and vital signs changes at four time points after operation in P0.05- 4 group. Conclusion: the optimal dose of sufentanil for patient-controlled intravenous analgesia after laparotomy is 2.5 渭 g / kg, i.e. the background dose is 0.05 渭 g / kg / kg, and the PCA dose is 0.05 渭 g / kg / kg).
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R614

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