地佐辛复合舒芬太尼用于全子宫切除患者硬膜外自控镇痛的效果观察(1)
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[摘要] 目的：观察地佐辛复合舒芬太尼用于全子宫切除患者术后硬膜外自控镇痛(PCEA)的效果及安全性。方法：选取我院择期行经腹全子宫切除患者100例，均为美国麻醉医师协会(ASA)分级Ⅰ～Ⅱ级。随机将其分为地佐辛复合舒芬太尼组(D组)和舒芬太尼组(S组)，每组各50例，术后均采用PCEA。镇痛泵药液配方，D组，地佐辛0.3 mg/kg+舒芬太尼1 μg/kg+左旋布比卡因3 mg/kg；S组，舒芬太尼2 μg/kg+左旋布比卡因3 mg/kg。两组药液均用生理盐水稀释至100 ml。记录两组患者术后4、8、12、24、48 h的疼痛强度评分和舒适度评分；记录48 h内患者自控镇痛(PCA)按压总次数和有效按压次数及舒芬太尼的累积用量；观察对比两组术后运动阻滞恢复时间、首次肛门排气时间以及术后镇痛期间患者恶心、呕吐、头晕、嗜睡、皮肤瘙痒和呼吸抑制等不良反应。结果：D组患者术后疼痛强度评分显著低于S组(P<0.05)，舒适度评分高于S组(P<0.05)；术后48 h内，D组PCA按压总次数和有效按压次数及舒芬太尼的累积用量均少于S组(P<0.05)；术后运动阻滞恢复时间和首次肛门排气时间，两组比较差异无统计学意义(P>0.05)；术后不良反应的发生，D组显著减少(P<0.05)。结论：地佐辛复合舒芬太尼用于全子宫切除患者硬膜外自控镇痛，效果确切，可减少舒芬太尼的用量，且并发症少，值得在临床麻醉中选用。
[关键词] 地佐辛；舒芬太尼；硬膜外；患者自控镇痛
[中图分类号] R614.42 [文献标识码] A [文章编号] 1673-7210(2011)12(a)-091-03
Curative effect observation on Dezocine combined with Sufentanil for patient-controlled epidural analgesia in patients with total hysterectomy
SHEN Qin
Department of Anesthesiology, Xinhua Hospital of Huainan City, Anhui Province, Huainan 232052, China
[Abstract] Objective: To observe the effect and safety of Dezocine combined with Sufentanil in patient-controlled epidural analgesia (PCEA) for total hysterectomy postoperative. Methods: 100 patients (ASA Ⅰ or Ⅱ) were randomly divided into Dezocine combined with Sufentanil group (group D) and Sufentanil group (group S), each group had 50 cases. All patients were used PCEA after surgery. Analgesia pump medicine in group D, Dezocine 0.3 mg/kg+Sufentanil 1 μg/kg+Levobupivacaine 3 mg/kg; in group S, Sufentanil 2 μg/kg+Levobupivacaine 3 mg/kg. The medicine was diluted with normal saline to 100 ml. The VAS score and BCS score of two groups at 4, 8, 12, 24, 48 h after surgery were recorded. Cumulative Sufentanil consumption, the total number of PCA press and times of effective press of two groups were recorded; the motor block recovery time, the first time of anal exhaust and the adverse reaction such as dizziness, somnolence, nausea, vomiting, skin itching and respiratory depression during postoperative analgesia were also recorded and compared ......
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