摘要
目的 :比较丁丙诺啡和曲马多两种长效镇痛药物联合用药不同配伍的PCIA药效及不良反应的临床观察。方法 :使用PCIA的病人 12 0例 ,随机分为三组 ,每组各 4 0例。药液配伍分别为 :Ⅰ组丁丙诺啡 0 .6mg ,曲马多 4 0 0mg,氟哌利多 2 .5mg。Ⅱ组丁丙诺啡 0 .9mg ,曲马多 4 0 0mg ,氟哌利多 2 .5mg。Ⅲ组丁丙诺啡 0 .6mg ,曲马多 6 0 0mg ,氟哌利多 2 .5mg。三组病人药液中均加入生理盐水至总量为 6 0ml的复合液。PCA设置 :负荷剂量 3ml,单次剂量 1ml,连续背景输注给药 0 .0 10～ 0 .0 15ml/ (kg·h) ,锁定时间 10min。观察术后 4、8、16、2 4、4 8h的BP、HR、RR、SpO2 、镇静、恶心、呕吐、眩晕、出汗、瘙痒、镇痛效果评分及药物用量。结果 :三组病人镇痛效果均满意 (P >0 .0 5 ) ,均无过度镇静和明显呼吸抑制 ,恶心、呕吐、眩晕、出汗等不良反应Ⅰ组比Ⅱ组和Ⅲ组发生率低 (P >0 .0 5 )。结论 :三组不同配伍的药液用于术后PCIA效果满意。Ⅰ组病人不良反应发生率低 ,是临床应用PCIA首选的最佳剂量。
Objective:To compare the analgesic and side effects of patient-controlled intravenous analgesia (PCIA) among different doses of buprenorphine and tramadol.Methods:One hundred and twenty patients were randomly divided into three groups(Ⅰ,Ⅱ,Ⅲ,each group n =40).Patient-controlled intravenous analgesia(PCIA) was set with three solutions:In group Ⅰ the patients received PCIA with 0.6mg of buprenorphine,400mg of tramadol,2.5mg of droperidol with 0.9%N.S 47ml/60ml.In group Ⅱ the patients received PCIA with 0.9mg of buprenorphine,400mg of tramadol,2.5mg of droperidol with 0.9%N.S 45ml/60.In group Ⅲ the patients received PCIA with 0.6mg of buprenorphine,600mg of tramadol,2.5mg of droperidol with 0.9%N.S 43ml/60ml.The loading doses were 3ml,bolus dose 1ml,background infusion 0.010～0.015ml/(kg·h),and lock-out time 10min.BP,HR,RR,SpO 2 and side effects (such as nausea,vomiting and dizziness)were monitored.The clinical effects were assessed by VAS score of pain and the number of PCIA pump by the patients.Results:All three solutions cauld provide better analgesia and patient satisfaction( P >0.05).All groups developed no excessive sedation and respiratory depression.Postoperative nausea,vomiting,dizziness and sweating were significantly less in group Ⅰ than in group Ⅱ and Ⅲ( P >0.05).Conclusion:Analgesic effects on PCIA with three mixtures of different doses of buprenorphine and tramadol were satisfactory.Group Ⅰ shows the lower rate of side effects and the dose is preferred in clinical use for PCIA.
出处
《重庆医科大学学报》
CAS
CSCD
2004年第6期817-819,共3页
Journal of Chongqing Medical University
关键词
病人静脉自控镇痛
丁丙诺啡
曲马多
Patient-controlled intravenous analgesia (PCIA)
Buprenorphine
Tramadol
