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舒芬太尼在术后病人自控硬膜外镇痛的应用 被引量:37

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摘要 目的比较不同浓度的舒芬太尼与罗比卡因复合应用于术后病人自控硬膜外镇痛(PCEA)中的镇痛效果及相关不良反应。方法36例择期全子宫切除术后的病人随机双盲均分为三组,术后硬膜外镇痛分别使用0.3μg/ml(A组)、0.4μg/ml(B组)和0.5μg/ml(C组)的舒芬太尼复合0.125%罗比卡因。镇痛泵设定持续输注背景剂量2 ml/h,PCA量每次3 ml,锁定时间30 min。分别于术后4、8、20、24、48 h观察病人的视觉模拟评分(VAS评分)、镇痛药的使用剂量、PCA的按压次数及不良反应。结果随着舒芬太尼浓度的增加,VAS评分、镇痛药用量、PCA按压次数逐渐下降,PCA按压次数比逐渐上升,术后48、h A组的VAS评分高于B组和C组(P<0.05或0.01),术后20 h A组的VAS评分高于C组(P<0.01)。术后4 h A组的镇痛药用量及PCA按压次数高于C组(P<0.05)。A组术后镇静、恶心、呕吐及皮肤瘙痒发生率低于C组(P<0.05)。结论舒芬太尼与罗比卡因复合应用于术后病人PCEA中的镇痛效果明确,不良反应发生率低。0.4μg/ml舒芬太尼与0.125%罗比卡因相配伍在获得满意镇痛效果的同时,引起相对少的不良反应,更适合在临床应用中推广。
出处 《临床麻醉学杂志》 CAS CSCD 2005年第10期706-708,共3页 Journal of Clinical Anesthesiology
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