摘要
目的探讨小剂量纳洛酮对芬太尼患者静脉自控镇痛（PCIA）效果及副作用的影响。方法选择50例全麻下行子宫切除术的患者，术后行48h PCIA，随机分为2组（每组25例）：Ⅰ组（芬太尼组）：芬太尼0．2μg·kg^-1·h^-1加生理盐水稀释至150ml；Ⅱ组（芬太尼复合纳洛酮组）：在Ⅰ组中加入纳洛酮0．05μg·kg^-1·h^-1记录术后PCIA治疗期间4、8、12、24、48h各时间点患者的镇痛和镇静评分、PCA有效按压次数及恶心、呕吐、呼吸抑制等不良反应。结果与Ⅰ组相比，Ⅱ组的VAS评分和PCA有效按压次数在术后48h内各时间点显著低，两组有统计学差异（P〈0．01）；Ⅱ组恶心、呕吐发生率也明显低于Ⅰ组（P〈0．05）。结论纳洛酮0．05bμg·kg^-1·h^-1可有效减少芬太尼PCIA的副作用，同时增强芬太尼的镇痛效果。
Objective To evaluate the effects of low dose naloxone on the analgesic efficacy and side-effects of fentanyl in patient-controlled intravenous analgesia （PCIA）. Methods Fifty female patients scheduled for abdominal hysterectomy under general anesthesia were enrolled in the study. All patients received 48-hours fentanyl PCIA after operation. They were divided randomly into two groups （n=25 for each group）. GroupⅠ ： fentanyl 0.2μg·kg^-1·h^-1 were added in 0.9% saline 150 ml. Group Ⅱ ： naloxone 0.05μg·kg^-1·h^-1 was added in Group Ⅰ ; Visual analogue scale （VAS） , sedation scores , times of PCA demanding and the incidence of side effects were recorded at 4, 8, 12, 24, 48 h after PCIA. Results Compared with group Ⅰ , VAS and times of PCA in group Ⅱ at each point in 48 hours were significant reduced （P〈0.01） and the incidence of nausea and vomiting were reduced in group Ⅱ , compared with group Ⅰ （P〈0.05）. Conclusion Naloxone at 0.05 μg·kg^-1·h^-1 can effectively enhance the analgesia effect while reduce the side-effects of fentanyl PCIA.
出处
《实用疼痛学杂志》
2009年第1期25-27,共3页
Pain Clinic Journal
关键词
芬太尼
纳洛酮
镇痛
患者自控
Fentanyl
Naloxone
Analgesia, Patient-Controlled
