酮咯酸氨丁三醇复合小剂量芬太尼与咪唑安定混合舒芬太尼在LC术后PCIA中的应用效果比较

doi:10.3969/j.issn.1671-7171.2018.04.026

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (0 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要【目的】比较酮咯酸氨丁三醇复合小剂量芬太尼与咪唑安定混合舒芬太尼在腹腔镜胆囊切除术(LC)术后患者静脉自控镇痛(PCIA)中的应用效果。【方法】选取2014年11月至2016年11月于本院就诊的行LC患者86例,随机分为2组各43例。A组予以咪唑安定混合舒芬太尼,B组予以酮咯酸氨丁三醇复合小剂量芬太尼,观察两组术后4 h、8 h、12 h、24 h PRINCE-ENRY评分,RAM-SAY镇静评分,总体镇痛效果,PCA镇痛次数及不良反应发生率。【结果】B组术后4 h、8 h、12 h、24 h PRINCE-ENRY评分和RAM-SAY镇静评分低于A组(P<0.05);B组术后总体镇痛效果在Ⅰ级所占比例明显高于A组,Ⅳ级所占比例明显低于A组(P<0.05);B组PCA总次数少于A组(P<0.05);B组不良反应发生率明显低于A组,差异均具有统计学意义(P<0.05)。【结论】LC术后采用酮咯酸氨丁三醇复合小剂量芬太尼与咪唑安定联合舒芬太尼镇痛,均可达到一定效果,相较而言,酮咯酸氨丁三醇复合小剂量芬太尼术后镇痛效果更佳,同时还可抑制阿片受体所产生的不良反应。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	杜彦茹

关键词 ：胆囊切除术, 腹腔镜, 酮咯酸氨丁三醇/治疗应用, 芬太尼/投药和剂量, 咪达唑仑/投药和剂量, 舒芬太尼/投药和剂量, 镇痛, 病人控制

Abstract：【Objective】To compare the effects of ketorolac tromethamine combined with low dose fentanyl and midazolam in combination with sufentanil in patient-controlled intravenous analgesia (PCIA) after laparoscopic cholecystectomy (LC).【Methods】A total of 86 patients with LC who admitted to our hospital from November 2014 to November 2016 were randomly divided into two groups, with 43 cases in each group. Patients in group A were treated with midazolam combined with sufentanil, while patients in group B received ketorolac tromethamine combined with a lower dose of fentanyl. The PRINCE-ENRY score, RAM-SAY sedation score, analgesic effect, overall PCIA analgesia and the incidence of adverse reactions at 4h, 8h, 12h and 24h after surgery were observed in the two groups.【Results】The PRINCE-ENRY score and RAM-SAY sedation score at 4h, 8h, 12h, 24h after surgery in group B were lower than those in group A; the difference between groups was significant statistically (P<0.05). The overall postoperative analgesic effect of group B in terms of the proportion of level Ⅰ was significantly higher than that of group A, while the proportion of level Ⅳ in group B was significant lower than that in the group A; the difference between groups was statistically significant (P<0.05). The total number of PCIA in group B was less than that in group A (P<0.05). The incidence of adverse reactions in group B was significantly lower than that in group A, and the difference was statistically significant (P<0.05).【Conclusion】The use of ketorolac tromethamine combined with fentanyl as well as midazolam combined with sufentanil can achieve certain effect after laparoscopic cholecystectomy. The combination of ketorolac tromethamine and low-dose fentanyl has relatively better postoperative analgesic effect and can also inhibit the opioid receptor induced adverse reactions.

Key words： Cholecystectomy, Laparoscopic Ketorolac Tromethamine/TU Fentanyl/AD Midazolam/AD Sufentanil/AD Analgesia,Patient-Controlled

收稿日期: 2017-07-24

PACS:

R657.4

引用本文:

杜彦茹. 酮咯酸氨丁三醇复合小剂量芬太尼与咪唑安定混合舒芬太尼在LC术后PCIA中的应用效果比较[J]. 医学临床研究, 2018, 35(4): 703-705,709.
DU Yan-ru. Effects of Ketorolac Tromethamine Combined with Low-dose Fentanyl and Midazolam in Combination with Sufentanil in Laparoscopic Cholecystectomy Patients after Patient-Controlled Intravenous Analgesia (PCIA). JOURNAL OF CLINICAL RESEARCH, 2018, 35(4): 703-705,709.

链接本文:

http://www.jcr.net.cn/CN/10.3969/j.issn.1671-7171.2018.04.026 或 http://www.jcr.net.cn/CN/Y2018/V35/I4/703

[1] 辜晓岚,鲁振,万梅方,等.氟比洛芬酯复合芬太尼用于胸科手术后镇痛[J].临床麻醉学杂志,2010,26(5):391-393.
[2] 张亚丽,李科.酮咯酸氨丁三醇联合舒芬太尼用于全髋关节置换术后自控镇痛的观察[J].大家健康(中旬版),2017,11(2):162-163.
[3] 朱学武,彭远帆,王勇,等.右美托咪定与咪唑安定联合瑞芬太尼对创伤患者机械通气时的镇静镇痛疗效比较[J].中国药业,2015,24(24):108-109.[4] 胡蓓.舒芬太尼与芬太尼联合布比卡因腰麻对前列腺电切术术后镇痛的效果[J].中国医药导报,2013,10(4):87-88,91.
[5] 田伟.腹腔镜胆囊切除术应用酮咯酸氨丁三醇对术后疼痛的疗效观察[J].中外医疗,2011,30(32):108-109.
[6] 李红新,詹锦六,劳燕萍,等.酮咯酸氨丁三醇复合芬太尼用于胸科手术术后镇痛的观察[J].临床肺科杂志,2011,16(8):1188-1189.
[7] 覃兴龙,焦文成.酮咯酸氨丁三醇在40例腹腔镜胆囊切除术超前镇痛中的应用[J].重庆医学,2010,39(9):1122-1124.
[8] 单文燕,孔高茵.芬太尼复合咪唑安定、昂丹司琼用于小儿术后静脉自控镇痛80例临床观察[J].医学临床研究,2011,28(10):1972-1973.
[9] 辜小芳,孙志军,陈韵岱,等.小剂量咪唑安定复合芬太尼在冠状动脉介入术中镇静镇痛效果观察与护理干预[J].中国药业,2011,20(9):53-54.
[10] 李明利,冯永文,吴明,等.右美托咪啶与咪唑安定对床旁气管切开时重症患者的影响[J].南昌大学学报(医学版),2011,51(1):65-67.
[11] 胡彦艳,秦丹丹,叶凤青,等.舒芬太尼复合氟比洛芬酯PCIA对老年肺癌根治术患者细胞免疫功能的影响[J].临床麻醉学杂志,2013,29(10):962-964.
[12] 陈信.咪唑安定联合芬太尼对危重患者机械通气镇静和镇痛的效果[J].西南国防医药,2016,26(8):865-868.
[13] 赵国良,赵中丽,杨静蕊,等.酮咯酸氨丁三醇复合芬太尼用于老年股骨头置换术后镇痛效果观察[J].山东医药,2016,56(2):43-44.
[14] 张生茂,韩亚升,包那日素,等.腹腔镜肾囊肿去顶减压手术术后应用酮咯酸氨丁三醇临床疗效的观察[J].内蒙古医学杂志,2016,48(9):1038-1041.
[15] 谢国柱,袁志国,卞丽玉,等.酮咯酸氨丁三醇对舒芬太尼用于老年病人术后镇痛的节俭作用[J].中华麻醉学杂志,2012,32(5):573-575.