摘要
目的观察低剂量纳布啡联合舒芬太尼自控静脉镇痛（PCIA）对妇科手术术后镇痛效果和不良反应的影响。方法选择ASAⅠ~Ⅱ级择期行妇科手术患者100例,均采用全身麻醉,术后行PCIA。患者随机分为舒芬太尼组（SF组）和纳布啡联合舒芬太尼组（NSF组）,每组50例。SF组镇痛泵配方为：舒芬太尼150μg、盐酸托烷司琼10mg加生理盐水稀释至100ml;NBS组在SF组基础上加10mg/L纳布啡1mg。观察两组患者术后2h,4h,6h,12h,24h,48h视觉模拟评分（VAS）、镇静程度评分（Ramesy）、48h内患者自控镇痛按压次数、患者总体满意度及术后不良反应等情况。结果两组配方均能为患者提供良好的术后镇痛,两组患者总的PCIA按压次数、VAS评分、Ramesy镇静评分差异无统计学意义。NSF组患者术后的总体满意度显著优于SF组（P〈0.05）,且恶心呕吐等不良反应更少。结论低剂量纳布啡联合舒芬太尼PCIA可以使患者阿片类药物相关性恶心呕吐症状的发生率降低,术后镇痛满意度提高。
Objective To investigate the effects of low-dose nalbuphine combined with sufentanil for patient-controlled intrave- nous analgesia{ PCIA} effect of analgesia after gynecological surgery and adverse reaction. Methods This study enrolled 100 female pa- tients, ASA I ~ Ⅱ, who were undergoing total abdominal hysterectomy, myomectomy, or ovarian tumor excision with general anesthesia. The patients were randomly divided into two groups-group of Sufentanil I SF ） and group of combination of Low-dose Nalbuphine and Sufentanil （NSF） ,50 cases in each group. In foe SF greup,the PCIA formula was Sufentanil 150lzg,Tropisetren hydrechloride 10mg plus saline diluted to 100ml. NSF group was based on the group of SF plus Nalhuphine （ 10mg/L ） 1 mg. The score of VAS and Ramesy and the PCIA requirement within 48h,overall patient satisfaction and opioid-related adverse enents were investigated at 2,4,6,12,24 and 48h postoperatively. Results Both groups of formula can provide patients with good postoperative analgesia. The numerical rating pain score and PCIA requirements were not significantly different between the two groups. The overall postoperative satisfaction of patients in group NSF was significantly better than that in group SF （ P 〈 0.05 ） , and has less adverse reactions such as nausea and vomiting. Conclusion Combination of low-dose nalbuphine and sufentanil in patient-controlled analgesia decreases incidence of opioid-related side effects and overall postoperative analgesia satisfaction is improved.
作者
张少杰
赵亚娟
李慧芳
王彬彬
王伟芝
ZHANG Shao-jie ZHAO Ya-juan LI Hui-fang WANG Bin-bin WANG Wei-zhi(~Department ofAnesthsiology, Weifang Medical University, Weifang 261053 ,China Department of Internal Medicine, Weifang Medical Universit Department of Anesthsiology, Weifang People＇s Hospital)
出处
《潍坊医学院学报》
2016年第5期330-332,共3页
Acta Academiae Medicinae Weifang
