不同剂量瑞芬太尼注射液对患者疼痛敏感度的影响

发布时间：2018-03-09 06:38

  本文选题：丙泊酚注射液　切入点：瑞芬太尼注射液　出处：《中国临床药理学杂志》2017年11期 　论文类型：期刊论文

【摘要】：目的观察丙泊酚联合不同剂量瑞芬太尼对患者疼痛敏感度的影响。方法 76例全身麻醉手术治疗的患者随机分为试验组和对照组,每组38例。试验组瑞芬太尼用量为4 ng·mL~(-1),对照组瑞芬太尼用量为2 ng·mL~(-1)。对患者用药前、插管前、插管后2,4,6 min的平均动脉压、舒张压、收缩压及心率进行记录,比较2组患者的疼痛分级与药物不良反应的发生情况。结果试验组的无痛发生率为76.32%(29/38例),对照组为26.31%(10/38例,P0.05)。插管前、插管后2,4,6 min,2组患者的平均动脉压、舒张压、收缩压、心率均呈不同程度的降低趋势。插管后6 min,试验组的平均动脉压为(74.32±6.66)mmHg,舒张压为(68.56±6.11)mmHg,收缩压为(96.86±14.65)mmHg,心率为(61.11±6.42)times·min~(-1);对照组分别为(75.53±7.11),(65.35±5.53),(95.32±13.53)mmHg和(62.42±5.21)times·min~(-1),差异均无统计学意义(均P0.05);2组与治疗前相比,差异均有统计学意义(均P0.05)。试验组出现发热1例、呼吸抑制1例、恶心2例、呕吐2例,药物不良反应发生率为15.79%(6/38例);对照组出现呕吐1例、眩晕1例、恶心2例、呼吸抑制3例,药物不良反应发生率为18.42%(7/38例),差异无统计学意义(P0.05)。结论 2,4 ng·mL~(-1)的瑞芬太尼均能减慢患者的心率,降低血压水平,但瑞芬太尼的药物用量为4 ng·mL~(-1)时,更能有效缓解患者注射丙泊酚的疼痛敏感度。
[Abstract]:Objective to observe the effect of propofol combined with remifentanil on pain sensitivity. Methods 76 patients undergoing general anesthesia were randomly divided into trial group and control group. There were 38 patients in each group. The dosage of remifentanil was 4 ng 路mL ~ (-1) in the trial group and 2 ng 路mL ~ (-1) in the control group. The mean arterial pressure, diastolic pressure, systolic pressure and heart rate were recorded before, before and after the intubation. Results the incidence of painless pain was 76.32 / 29 / 28 in the trial group and 26.31 / 10 / 10 / 10 / 38 in the control group (P < 0.05). The mean arterial pressure, diastolic pressure, systolic blood pressure were measured before intubation and 2 minutes after intubation. At 6 min after intubation, the mean arterial pressure, diastolic pressure, systolic pressure and heart rate were 74.32 卤6.66nhg, 68.56 卤6.11hg, 96.86 卤14.65mHg, 61.11 卤6.42times 路min-1, respectively, in the control group (75.53 卤7.11hg, 95.32 卤13.53mmHg and 62.42 卤5.21times 路min-1), respectively. There was no significant difference between the two groups. The difference was statistically significant (P 0.05). There were 1 case of fever, 1 case of respiratory depression, 2 cases of nausea and 2 cases of vomiting in the experimental group, and the incidence of adverse drug reaction was 15.79% in 6 / 38 cases, while in the control group, vomiting occurred in 1 case, vertigo in 1 case, nausea in 2 cases. There were 3 cases of respiratory depression, and the incidence of adverse drug reactions was 18.42 / 7 / 38. There was no significant difference (P 0.05). Conclusion remifentanil (2ng 路mL ~ (-1)) can decrease heart rate and blood pressure level, but when remifentanil dosage is 4 ng 路mL ~ (-1), remifentanil can decrease the heart rate and blood pressure level of the patients, but the dosage of remifentanil is 4 ng 路mL ~ (-1). More effective in reducing the pain sensitivity of patients injected with propofol.
【作者单位】： 杭州师范大学附属医院麻醉科;浙江省立同德医院麻醉科;
【基金】：浙江省医药卫生科技基金资助项目(2012KYB046)
【分类号】：R614
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