芬太尼复合液PCIA或PCNA用于上肢骨折术后镇痛的效果观察
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【摘 要】 目的 观察上肢骨折手术后采用芬太尼复合液经臂丛鞘内患者自控镇痛(PCNA)的效果。方法 40例上肢骨折手术后患者随机分为两组：臂丛鞘内患者自控镇痛组(PCNA组)和静脉患者自控镇痛组(PCIA组)各20例。手术结束前20 min两组患者均予连接自控镇痛泵。PCNA组用0.125%罗哌卡因+芬太尼0.4 mg+氟哌利多5 mg复合液,总量100 ml；PCIA组用芬太尼0.8～1 mg+氟哌利多5 mg+生理盐水。结果 两组患者的一般情况、年龄、体质量、性别差异无统计学意义；PCIA组SBP、HR与术前比较高；PCNA组循环无明显变化。术后4～48 h的VAS评分PCNA组低于PCIA组。结论 芬太尼复合液经鞘内PCA用药或经静脉PCA用药，安全有效，但鞘内用药的镇痛质量优于静脉用药组。
【关键词】 上肢骨折；鞘内患者自控镇痛；静脉患者自控镇痛
The analgesic effect after the operation of upper-arm fracture with infused fentanyl into brachial plexus or intravenousZHANG Jing,CHEN Ming-hong,CAO Ji-hong,et al.The Sheko People′s Hospital of Nanshan Strict,Shenzhen,Guangdong Province,Shenzhen 518067,China【Abstract】 Objective To observe the analgesic effect after the operation ofupper-arm fracture when infused fentanyl into brachial plexus or intravenous.Methods 40 patients were randomly devided into two groups with 20 patients in each group：Group PCNA：patients controlled nerveblokade analgesia which used fentanyl 0.4 mg,ropivacaine 0.125 mg and dropiridol 5 mg;Group PCIA:patients controlled intravenous analgesiawhich used fentanyl 0.8～1.0 mg and dropiridol 5 mg,patients in two groups began to use the analgesia pump 20 minutes before the end of operation.Results there isno obvious change of circulation in group PCNA ......
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