摘要
目的观察和比较开胸手术患者使用羟考酮联合氟比洛芬酯与芬太尼联合氟比洛芬酯镇痛的有效性。方法选择择期开胸手术患者80例,男53例,女24例,年龄40~65岁,ASAⅠ~Ⅲ级,随机分为两组。于手术结束前15min分别静注羟考酮0.1mg/kg（O组）或芬太尼1μg/kg（F组）,术后均行PCIA,镇痛泵配方为羟考酮0.8mg/kg（O组）或芬太尼8μg/kg（F组）＋氟比洛芬酯4mg/kg＋昂丹司琼8mg＋生理盐水至150ml。记录术后2、6、12、24、36、48h的静止和咳嗽状态VAS疼痛评分和Ramsay镇静评分;记录术后48h内PCIA有效及无效按压次数、镇痛药追加例数和不良反应情况。结果术后2~48h静息和咳嗽时O组VAS疼痛评分明显低于F组（P〈0.01或P〈0.05）。两组不同时点Ramsay镇静评分差异无统计学意义。O组PCIA有效按压次数、无效按压次数和镇痛药追加例数明显少于F组（P〈0.05）。O组恶心、呕吐等不良反应发生率明显低于F组（P〈0.05）。结论羟考酮联合氟比洛芬酯可有效地缓解开胸术后疼痛,等药剂量药物镇痛效果似强于芬太尼联合氟比洛芬酯,且不良反应更少。
Objective To observe the efficacy of oxycodone or fentanyl combined with flurbiprofen esters（FA）for postoperative analgesic after thoracic surgery.Methods Eighty patients,53 males and 24 females,aged 40-65 years,ASA physical statusⅠ-Ⅲ,undergoing elective thoracotomy surgery,randomly divided into two groups（n=40each）.Oxycodone 0.1mg/kg（group O）or fentanyl 1μg/kg（group F）were intravenously injected 15 minutes before the end of surgery.Each patient was given PCIA,with solution including oxycodone 0.8mg/kg plus FA 4 mg/kg plus ondansetron 8 mg plus 0.9% NaCl（150ml）in group O and fentanyl 8μg/kg plus FA 4mg/kg plus ondansetron 8mg plus 0.9% NaCl（150 ml）in group F.The coughing and resting visual analogue scale（VAS）,Ramsay score at 2,6,12,24,36 and 48hours after operation,complications,the times of patient controlled pressing and requirement for rescue analgesic were evaluated.Results Compared with group F,the resting and coughing VAS at 2,6,12,24,36 and 48 hours after operation,requirement for rescue analgesic,the incidence of nausea and vomiting and the times of patient controlled pressing were significantly lower in group O（P〈0.05）.There was no significantly difference in the Ramsay score.Conclusion It is effective that the patients undergoing thoracic surgery used the PCIA of oxycodone combined FA to control the postoperative pain,and analgesic effect more excellent than fentanyl combined FA,and with fewer side effects.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2016年第12期1183-1185,共3页
Journal of Clinical Anesthesiology
关键词
羟考酮
氟比洛芬酯
镇痛
开胸手术
Oxycodone
Flurbiprofen esters
Analgesia
Thoracic surgery
