地佐辛复合舒芬太尼用于全麻开胸患者术后静脉镇痛的临床观察

发布时间：2018-03-16 14:22

本文选题：地佐辛　切入点：舒芬太尼　出处：《实用药物与临床》2016年03期 　论文类型：期刊论文

【摘要】：目的观察比较地佐辛复合舒芬太尼用于全麻患者开胸术后自控静脉镇痛的效果。方法选择择期ASAⅠ或Ⅱ级全麻开胸手术患者60例,年龄20~60岁,随机分为3组。舒芬太尼组(S组,20例,舒芬太尼3.5μg/kg+昂丹司琼24 mg);地佐辛组(D组,20例,地佐辛0.8 mg/kg+昂丹司琼24 mg);地佐辛复合舒芬太尼组(SD组,20例,地佐辛0.4 mg/kg+舒芬太尼1.75μg/kg+昂丹司琼24 mg);均用生理盐水稀释到100 m L。各组均采用微量注射泵静脉输注右美托咪定负荷剂量1μg/kg麻醉诱导,15 min泵注完,静注舒芬太尼0.2~0.4μg/kg、丙泊酚1.5~2 mg/kg、罗库溴铵1 mg/kg后气管插管,麻醉维持以右美托咪啶0.2μg/(kg·h)持续泵注、吸入1.5%~2.5%七氟烷、泵注丙泊酚2~3 mg/(kg·h)和间断静注罗库溴铵0.2~0.3 mg/kg。术毕接PCIA泵,参数设定均以2 m L/h持续静脉泵入,单次量0.5 m L,锁定时间15 min。监测治疗前(T0)及治疗后4 h(T_1)、8h(T_2)、12 h(T_3)、24 h(T_4)、36 h(T_5)的SBP、DBP、HR、RR、Sp O2。并记录VAS镇痛评分、Ramsay镇静评分。观察患者不良反应、患者满意度等。结果 T0~T4时SD组RR低于S组和D组,差异有统计学意义(P0.05);T0~T5时SD组Sp O2低于S组和D组,差异有统计学意义(P0.05)。T1~T5时SD组Ramsay镇静评分低于S组和D组,差异有统计学意义(P0.05)。SD组不良反应发生率低于S组,满意度优秀率高于S组和D组,差异有统计学意义(P0.05)。结论地佐辛复合舒芬太尼用于全麻开胸患者术后静脉镇痛,两药在药效上有很好的协同作用,使患者心血管系统平稳,呼吸抑制轻微,镇痛效果确切,不良反应少。
[Abstract]:Objective to observe and compare the efficacy of dizosin combined with sufentanil in patient-controlled intravenous analgesia after thoracotomy in patients with general anesthesia. They were randomly divided into three groups: sufentanil group (n = 20), sufentanil (3.5 渭 g / kg) group (n = 20), D group (n = 20), dizosin group (n = 20), dizosin 0.8 mg/kg, ondansetron group (n = 20), dizosin combined with sufentanil group (n = 20), SD group (n = 20). Dizosin 0.4 mg/kg sufentanil 1.75 渭 g / kg ondansetron 24 mg / kg was diluted to 100ml with normal saline. Each group was infused intravenously with dexmetidine (1 渭 g / kg) for 15 min. Sufentanil 0.2 渭 g / kg, propofol 1.5 mg / kg, rocuronium 1 mg/kg tracheal intubation, anesthesia maintained with dexmetidine 0.2 渭 g / kg / kg 路h) continuous pump, 1.5% 2.5% sevoflurane, pump propofol 23 mg/(kg 路h) and intermittent intravenous injection of rocuronium 0.2 卤0.3 mg / kg. The parameters were continuously pumped into the vein at 2 mL / h for a single dose of 0.5 mL, and the locking time was 15 mins. Monitoring T0 before treatment and 4 h after treatment, and 4 h after treatment, the SBPDBPHR-RRSp O2.The adverse reactions of the patients were observed by observing the adverse reactions of the patients, and observing the adverse reactions of the patients. Results the RR of SD group was lower than that of S group and D group at T0 / T4 time, and the difference was statistically significant (P 0.05). SPO _ 2 in SD group was lower than that in S group and D group at T0 / T _ 4, and the Ramsay sedation score in SD group was lower than that in S group and D group at T0 / T _ 4. The difference was statistically significant in the incidence of adverse reactions and satisfactory rate in group S and group D. the difference was statistically significant (P 0.05). Conclusion Dizoxin combined with sufentanil is used for postoperative intravenous analgesia in patients undergoing general anesthesia. The two drugs have a good synergistic effect on the efficacy, which makes the cardiovascular system stable, mild respiratory inhibition, precise analgesic effect and less adverse reactions.
【作者单位】：沈阳军区总医院麻醉科;武警辽宁省总队医院麻醉科;
【分类号】：R614

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