摘要
目的：观察舒芬太尼用于肝脏术后硬膜外患者自控镇痛(PCEA)或静脉患者自控镇痛(PCIA)效应。方法：80例 ASA Ⅰ～Ⅱ择 期行肝脏手术患者，随机分为4组(n=20) 。术后行 PCEA(背景剂量4ml/h+PCA 4ml/次，锁定时间8min)或 PCIA(背景剂量为 2． 5ml/h+PCA 5ml/次，锁定时间8min)。Bf 组镇痛用药为硬膜外0． 125%布比卡因+2mg/ml 芬太尼；Bs 组镇痛用药为硬膜外 0． 125%布比卡因+0． 4mg/ml 舒芬太尼；S 组镇痛用药为静脉0． 8mg/ml 舒芬太尼；F 组镇痛用药为静脉4mg/ml 芬太尼。观察术后 2，4，8，12，24，48h 镇痛(VAS)和镇静效果、镇痛泵使用情况；记录血压、脉搏和呼吸频率的变化及恶心、呕吐等不良反应。结果：4组患 者均镇痛良好。Bs 组各时点的镇痛评分最低，与 S 组相比2、 4、 48h 镇痛评分有显著差异(P＜0． 05) ，与 Bf 组比无显著差异(P＞ 0． 05) 。S 组较 F 组8、 12、 24h 镇痛评分低(P＜0． 05) ，Bs 组镇痛泵按压次数和镇痛药物使用量最少，与其它三组比有显著差异(P＜ 0． 05) 。四组不良反应发生率无显著差异。四组生命体征稳定。结论：舒芬太尼镇痛是可行、安全、有效的，可在临床推广。
Objective： To Evaluate the value and side effects of patient-controlled epidural or intravenous analgesia with sufentanil after hepatotomy. Methods： 80 cases graded ASAⅠ～Ⅱ after hepatotomy were randonly divided into four groups. Group Bf, Bs, S and F （n = 20 in each group） received PCEA with 0. 125% bupivacaine ＋ 2mg/ml fentanil, PCEA with 0. 125% bupivacaine ＋ 0. 5mg/ml sufentanil, PCIA with 0. 8mg/ml sufentanil, PCIA with 4rng/ml fentanil respectively. PCEA include background 4ml/h and bolus of 4ml with lockout-time 8 minutes. PCIA include background 2. 5ml/h and bolus of 5ml with lockout-time 8 minutes. Postoperative analgesia was assessed by recording the PCA requirements and the patients, visual analog scale（VAS） at 2h, 4h,Sh,12h,24h, 48h after operation. Sedation analogue scales and side effects were also recorded. Results： All groups showed good pain relief. In the Bs group , VAS was lower than that in the S group at 2h, 4h, 48h（P〈0.05）. But there was no significant difference between Bs and Bf group in VAS. In the S group , VAS was significantly lower than in the F group at 8h, 12h,24h（P〈0.05）. Comparing with other three groups, the requirements of PCA was the least in the Bs group（P〈0. 05）. There were no differences in side effects in all groups. Conclusion： Postoperative analgesia with sufentanil was proved to be a good method to manage postoperative pain after hepatotomy for patients.
出处
《中国临床医学》
北大核心
2005年第5期913-915,共3页
Chinese Journal of Clinical Medicine
