本文關(guān)鍵詞： 舒芬太尼 靜脈自控鎮(zhèn)痛 開(kāi)腹手術(shù)　出處：《廣西醫(yī)科大學(xué)》2015年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的：比較不同劑量舒芬太尼用于開(kāi)腹手術(shù)術(shù)后靜脈自控鎮(zhèn)痛(PCIA)的效果,擇出最佳劑量,為開(kāi)腹手術(shù)病人術(shù)后PCIA用藥提供參考。方法：將擇期行開(kāi)腹手術(shù)并要求行術(shù)后靜脈自控鎮(zhèn)痛的120例患者,隨機(jī)分為4組(n=30)：A組、B組、C組、D組術(shù)后分別以1.5、2.0、2.5、3.0μg/kg舒芬太尼配制術(shù)后靜脈自控鎮(zhèn)痛用藥,每組加入鹽酸甲氧氯普胺注射液20mg,用0.9%氯化鈉注射液稀釋成150ml。鎮(zhèn)痛泵參數(shù)設(shè)置：背景劑量3ml/h,PCA劑量3ml/次,負(fù)荷劑量為0ml,鎖定時(shí)間20min。分別于術(shù)后6h (T1)、12h (T2)、24h(T3)、48h(T4)對(duì)患者進(jìn)行回訪(fǎng),并進(jìn)行痛疼評(píng)分、鎮(zhèn)靜評(píng)分等,記錄患者各個(gè)時(shí)間點(diǎn)的生命體征及不良反應(yīng)。結(jié)果：D組患者術(shù)后四個(gè)時(shí)點(diǎn)的PCIA鎮(zhèn)痛效果明顯優(yōu)于A(yíng)、B、C組(P0.05),而C組患者術(shù)后四個(gè)時(shí)點(diǎn)的PCIA鎮(zhèn)痛效果明顯優(yōu)于A(yíng)、B組(P0.05)。D組的PCA按壓次數(shù)明顯少于A(yíng)、B、C組(P0.05),而C組的PCA按壓次數(shù)則明顯少于A(yíng)、B組(P0.05)。然而,D組患者惡心嘔吐評(píng)分和頭暈的發(fā)生率明顯高于其他3組(P0.05),而其他3組的不良反應(yīng)無(wú)明顯差異(P0.05)。4組患者術(shù)后四個(gè)時(shí)點(diǎn)的鎮(zhèn)靜評(píng)分和生命體征改變的比較,差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論：舒芬太尼用于開(kāi)腹手術(shù)后靜脈自控鎮(zhèn)痛的最適配藥劑量為2.5μg/kg,即背景劑量為O.05μg/(kg·h), PCA劑量為0.05μg/(kg·次)
[Abstract]:Objective: to compare the effects of different doses of sufentanil for postoperative patient-controlled intravenous analgesia (PCIA) after laparotomy, and to select the best dose. Methods: one hundred and twenty patients who underwent open surgery and required postoperative patient-controlled intravenous analgesia were treated with PCIA. Four groups were randomly divided into 4 groups: group B, group B, group C and group D were treated with 2.5 渭 g / kg sufentanil, respectively, for postoperative patient-controlled analgesia. Each group was added 20 mg methoxyclopramide hydrochloride injection and diluted into 150 ml with 0.9% sodium chloride injection. The parameters of the analgesic pump were as follows: the background dose was 3 ml / h, the loading dose was 0 ml, the locking time was 20 min. The patients were visited at 6 h after operation. Pain score, sedation score, etc. Results the analgesic effect of PCIA at four time points in group D was significantly better than that in group C (P 0.05), but the analgesic effect of PCIA in group C was better than that in group A B (P 0.05). The times of PCA compression in group C were significantly less than those in group A (P 0.05), but the times of PCA compression in group C were significantly less than those in group A (B). However, the incidence of nausea and vomiting score and dizziness in group D was significantly higher than that in group A (P 0.05), but the adverse reactions in the other three groups were not obvious. Comparison of sedation scores and vital signs changes at four time points after operation in P0.05- 4 group. Conclusion: the optimal dose of sufentanil for patient-controlled intravenous analgesia after laparotomy is 2.5 渭 g / kg, i.e. the background dose is 0.05 渭 g / kg / kg, and the PCA dose is 0.05 渭 g / kg / kg).
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類(lèi)號(hào)】：R614

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本文編號(hào)：1527707