本文關(guān)鍵詞： 鹽酸羥考酮 婦科腹腔鏡 術(shù)后鎮(zhèn)痛　出處：《青島大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:探討鹽酸羥考酮注射液對(duì)于減少婦科腹腔鏡手術(shù)術(shù)后疼痛的有效性以及安全性,為臨床工作提供重要參考,指導(dǎo)臨床麻醉用藥。方法:經(jīng)倫理委員會(huì)批準(zhǔn)及患者知情同意后,選擇80例擇期全麻下婦科腹腔鏡手術(shù)患者,年齡20~50歲,ASAⅠ~Ⅱ級(jí)。采用隨機(jī)數(shù)字表法,將所有患者分為2組(n=40):鹽酸羥考酮注射液組(Oxycodone,O組)和枸櫞酸芬太尼注射液組(Fentnyl,F組)。關(guān)腹前5min,O組給予靜脈注射鹽酸羥考酮注射液10mg;F組予靜脈注射枸櫞酸芬太尼注射液0.1mg。記錄拔管時(shí)間,拔管后于PACU中觀察1小時(shí),評(píng)估并記錄其拔管后15min、30min及60min的VAS疼痛數(shù)字評(píng)分和Ramsay鎮(zhèn)靜評(píng)分,觀察是否有呼吸抑制等不良反應(yīng)。術(shù)后24小時(shí)內(nèi)按既定時(shí)間點(diǎn)(即術(shù)后2h、4h、8h、12h和24h)評(píng)估并記錄患者靜息和活動(dòng)時(shí)(咳嗽、翻身或行走)的VAS評(píng)分,術(shù)后首次VAS≥4分的時(shí)間和術(shù)后要求追加鎮(zhèn)痛的例數(shù)并觀察術(shù)后24小時(shí)內(nèi)有無(wú)惡心、嘔吐及皮膚瘙癢等不良反應(yīng),記錄術(shù)后肛門排氣時(shí)間以及評(píng)價(jià)患者對(duì)鎮(zhèn)痛的滿意度并行舒適度評(píng)分(BCS)。結(jié)果:兩組患者年齡、體重指數(shù)、手術(shù)時(shí)間和術(shù)后拔管時(shí)間差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);拔管后15min、30min、60min VAS疼痛評(píng)分和Ramsay鎮(zhèn)靜評(píng)分差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),兩組均無(wú)呼吸抑制情況發(fā)生;O組在術(shù)后2h、4h和8h的VAS疼痛評(píng)分顯著低于F組(P0.05),術(shù)后12~24小時(shí)兩組的VAS疼痛評(píng)分差異無(wú)統(tǒng)計(jì)學(xué)意義;O組術(shù)后首次VAS≥4分的時(shí)間比F組明顯延長(zhǎng)(P0.05),而且術(shù)后要求追加鎮(zhèn)痛的例數(shù)少于F組(P0.05);與F組比較,O組患者術(shù)后惡心、嘔吐的發(fā)生率更低(P0.05);兩組患者術(shù)后24小時(shí)舒適度評(píng)分差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);與F組比較,O組患者的滿意度高,結(jié)果有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:鹽酸羥考酮注射液作為唯一的雙阿片受體激動(dòng)劑,用于婦科腹腔鏡手術(shù)后鎮(zhèn)痛效果非常明確,不但能有效減輕婦科微創(chuàng)術(shù)后早期疼痛,而且其具有明顯針對(duì)性的鎮(zhèn)痛時(shí)效;經(jīng)臨床觀察與枸櫞酸芬太尼比較,鹽酸羥考酮不良反應(yīng)的發(fā)生率也明顯降低。
[Abstract]:Objective: to investigate the efficacy and safety of hydroxycodone hydrochloride injection in reducing postoperative pain of gynecological laparoscopic surgery, and to provide important reference for clinical work. Methods: 80 patients with gynecological laparoscopic surgery under general anesthesia were selected after the approval of ethics committee and informed consent. All the patients were divided into two groups by random digital table: Oxycodone hydrochloride injection group. Group O) and fentanyl citrate injection group (group F). In group F, 0.1 mg fentanyl citrate injection was injected intravenously. The extubation time was recorded and observed in PACU for 1 hour after extubation. The results were evaluated and recorded 15 minutes after extubation. The scores of VAS pain number and Ramsay sedation were measured at 30min and 60min, and the adverse reactions such as respiratory inhibition were observed. VAS scores of rest and activity (coughing, turning over or walking) were assessed and recorded at 4 h, 8 h, 12 h and 24 h. The time of the first postoperative VAS 鈮，

本文編號(hào)：1453782