地佐辛静脉或硬膜外术后患者自控镇痛在妇科手术应用的比较

发布时间：2018-05-03 12:13

本文选题：地佐辛 + 硬膜外　；参考：《中国医院药学杂志》2017年08期

【摘要】：目的:比较地佐辛静脉或硬膜外术后患者自控镇痛(patient controled analgesia,PCA)在妇科手术应用的效果及不良反应。方法:选取行妇科开腹手术患者60例。在手术结束后接电子镇痛泵与患者的静脉输液管或硬膜外管,I(Patient Controled Intravenous Analgesia,PCIA)组,泵内药物配方为地佐辛0.8 mg·kg~(-1),用生理盐水配至100 mL;E(Patient Controled Epidural Analgesia,PCEA)组,泵内药物为地佐辛0.4 mg·kg~(-1)+罗哌卡因20 mg,用生理盐水配至100 mL;2组背景输注为2mL·h~(-1),单次按压注射量(bolus dose)为0.5 mL,锁定15 min。观察并记录患者2,4,8,12,24 h疼痛评分、镇静评分、舒适度评分,满意度评分。疼痛评分(采用VAS标准:0为无痛,10为最剧烈痛),按压次数,总药量,满意度评分:0-10分。不良反应(包括:恶心呕吐,尿潴留,嗜睡,呼吸抑制,皮肤瘙痒)。结果:术后2 h VAS(3.14±2.36 vs 1.84±2.01,P0.05)、总按压次数(11.48±23.69 vs 2.87±9.55,P0.05)和恶心呕吐发生率(33%vs 13%,P0.05),PCIA组均高于PCEA组,2组间比较差异有统计学意义。结论:静脉地佐辛和硬膜外地佐辛复合罗哌卡因皆可安全有效地用于患者术后自控镇痛,均能获得较高的满意度。但PCEA组在镇痛效果更佳,恶心呕吐发生率较低。
[Abstract]:Objective: to compare the efficacy and side effects of patient controled analgesia after dizosin vein or epidural surgery. Methods: 60 patients undergoing gynecological surgery were selected. At the end of the operation, the patients were treated with electronic analgesia pump and intravenous infusion tube or epidural Controled Intravenous analgesia after operation. The drug formula was dizosin 0.8 mg / kg / kg ~ (-1) and 100 mL / L of saline was added to the group of 100ml / L of epigastric Controled Epidural analgesia (PCEA), respectively, in which the dosage of dizosin was 0.8 mg / kg / kg ~ (-1) and 100 mL of saline was added to the group of intravenous infusion or epidural tube / epidural analgesia (PCEA). The drug in pump was dizosin 0.4 mg kg / kg) ropivacaine 20 mg / g. The background infusion of ropivacaine to 100ml / L group was 2mL halium (1), the single dose of bolus dosewas 0.5 mL, and the locking time was 15 min. The 24 h pain score, sedation score, comfort score and satisfaction score were observed and recorded. Pain score (VAS Standard: 0: 10 was used as the most severe pain score), the times of pressing, the total dosage, and the satisfaction score: 0-10. Adverse reactions (including nausea and vomiting, retention of urine, lethargy, respiratory inhibition, and itching of skin). Results: at 2 h after operation, VAS(3.14 卤2.36 vs 1.84 卤2.01g P0.05, total compression times (11.48 卤23.69 vs 2.87 卤9.5 P0.05) and incidence of nausea and vomiting were significantly higher in PCIA group than in PCEA group. Conclusion: both intravenous dizosin and epidural zoxin combined with ropivacaine can be safely and effectively used in postoperative patient-controlled analgesia. In PCEA group, the analgesic effect was better and the incidence of nausea and vomiting was lower.
【作者单位】：首都医科大学附属潞河医院麻醉科;中国医学科学院整形外科医院;
【分类号】：R614

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