本文選題：地佐辛　切入點(diǎn)：舒芬太尼　出處：《實(shí)用藥物與臨床》2016年03期 　論文類(lèi)型：期刊論文

【摘要】：目的觀察比較地佐辛復(fù)合舒芬太尼用于全麻患者開(kāi)胸術(shù)后自控靜脈鎮(zhèn)痛的效果。方法選擇擇期ASAⅠ或Ⅱ級(jí)全麻開(kāi)胸手術(shù)患者60例,年齡20~60歲,隨機(jī)分為3組。舒芬太尼組(S組,20例,舒芬太尼3.5μg/kg+昂丹司瓊24 mg);地佐辛組(D組,20例,地佐辛0.8 mg/kg+昂丹司瓊24 mg);地佐辛復(fù)合舒芬太尼組(SD組,20例,地佐辛0.4 mg/kg+舒芬太尼1.75μg/kg+昂丹司瓊24 mg);均用生理鹽水稀釋到100 m L。各組均采用微量注射泵靜脈輸注右美托咪定負(fù)荷劑量1μg/kg麻醉誘導(dǎo),15 min泵注完,靜注舒芬太尼0.2~0.4μg/kg、丙泊酚1.5~2 mg/kg、羅庫(kù)溴銨1 mg/kg后氣管插管,麻醉維持以右美托咪啶0.2μg/(kg·h)持續(xù)泵注、吸入1.5%~2.5%七氟烷、泵注丙泊酚2~3 mg/(kg·h)和間斷靜注羅庫(kù)溴銨0.2~0.3 mg/kg。術(shù)畢接PCIA泵,參數(shù)設(shè)定均以2 m L/h持續(xù)靜脈泵入,單次量0.5 m L,鎖定時(shí)間15 min。監(jiān)測(cè)治療前(T0)及治療后4 h(T_1)、8h(T_2)、12 h(T_3)、24 h(T_4)、36 h(T_5)的SBP、DBP、HR、RR、Sp O2。并記錄VAS鎮(zhèn)痛評(píng)分、Ramsay鎮(zhèn)靜評(píng)分。觀察患者不良反應(yīng)、患者滿意度等。結(jié)果 T0~T4時(shí)SD組RR低于S組和D組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);T0~T5時(shí)SD組Sp O2低于S組和D組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。T1~T5時(shí)SD組Ramsay鎮(zhèn)靜評(píng)分低于S組和D組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。SD組不良反應(yīng)發(fā)生率低于S組,滿意度優(yōu)秀率高于S組和D組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論地佐辛復(fù)合舒芬太尼用于全麻開(kāi)胸患者術(shù)后靜脈鎮(zhèn)痛,兩藥在藥效上有很好的協(xié)同作用,使患者心血管系統(tǒng)平穩(wěn),呼吸抑制輕微,鎮(zhèn)痛效果確切,不良反應(yīng)少。
[Abstract]:Objective to observe and compare the efficacy of dizosin combined with sufentanil in patient-controlled intravenous analgesia after thoracotomy in patients with general anesthesia. They were randomly divided into three groups: sufentanil group (n = 20), sufentanil (3.5 渭 g / kg) group (n = 20), D group (n = 20), dizosin group (n = 20), dizosin 0.8 mg/kg, ondansetron group (n = 20), dizosin combined with sufentanil group (n = 20), SD group (n = 20). Dizosin 0.4 mg/kg sufentanil 1.75 渭 g / kg ondansetron 24 mg / kg was diluted to 100ml with normal saline. Each group was infused intravenously with dexmetidine (1 渭 g / kg) for 15 min. Sufentanil 0.2 渭 g / kg, propofol 1.5 mg / kg, rocuronium 1 mg/kg tracheal intubation, anesthesia maintained with dexmetidine 0.2 渭 g / kg / kg 路h) continuous pump, 1.5% 2.5% sevoflurane, pump propofol 23 mg/(kg 路h) and intermittent intravenous injection of rocuronium 0.2 鹵0.3 mg / kg. The parameters were continuously pumped into the vein at 2 mL / h for a single dose of 0.5 mL, and the locking time was 15 mins. Monitoring T0 before treatment and 4 h after treatment, and 4 h after treatment, the SBPDBPHR-RRSp O2.The adverse reactions of the patients were observed by observing the adverse reactions of the patients, and observing the adverse reactions of the patients. Results the RR of SD group was lower than that of S group and D group at T0 / T4 time, and the difference was statistically significant (P 0.05). SPO _ 2 in SD group was lower than that in S group and D group at T0 / T _ 4, and the Ramsay sedation score in SD group was lower than that in S group and D group at T0 / T _ 4. The difference was statistically significant in the incidence of adverse reactions and satisfactory rate in group S and group D. the difference was statistically significant (P 0.05). Conclusion Dizoxin combined with sufentanil is used for postoperative intravenous analgesia in patients undergoing general anesthesia. The two drugs have a good synergistic effect on the efficacy, which makes the cardiovascular system stable, mild respiratory inhibition, precise analgesic effect and less adverse reactions.
【作者單位】： 沈陽(yáng)軍區(qū)總醫(yī)院麻醉科;武警遼寧省總隊(duì)醫(yī)院麻醉科;
【分類(lèi)號(hào)】：R614

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