[1]颜娅,何才,戴珩,等.不同剂量纳布啡联合芬太尼对腹腔镜子宫肌瘤挖除术患者术后镇痛的效果分析[J].第三军医大学学报,2018,40(17):1595-1598.
 YAN Ya,HE Cai,DAI Heng,et al.Analgesic effect of different doses of nalbuphine combined with fentanyl by patient-controlled intravenous analgesia for patients after laparoscopic myomectomy[J].J Third Mil Med Univ,2018,40(17):1595-1598.
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不同剂量纳布啡联合芬太尼对腹腔镜子宫肌瘤挖除术患者术后镇痛的效果分析(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
40卷
期数:
2018年第17期
页码:
1595-1598
栏目:
临床医学
出版日期:
2018-09-15

文章信息/Info

Title:
Analgesic effect of different doses of nalbuphine combined with fentanyl by patient-controlled intravenous analgesia for patients after laparoscopic myomectomy
作者:
颜娅何才戴珩罗密李有长
重庆市妇幼保健院麻醉科
Author(s):
YAN Ya HE Cai DAI Heng LUO Mi LI Youchang

Department of Anesthesiology, Chongqing Health Center for Women and Children, Chongqing, 401147, China

关键词:
纳布啡术后镇痛不良反应腹腔镜子宫肌瘤挖除术
Keywords:
nalbuphine patient-controlled intravenous analgesia adverse reaction laparoscope myomectomy
分类号:
R614.24; R713.4; R971.3
文献标志码:
A
摘要:

目的    探讨纳布啡联合芬太尼用于腹腔镜子宫肌瘤挖除术患者的术后镇痛效果及适宜的配制剂量。方法    选择2017年7-12月在我院行腹腔镜下子宫肌瘤挖除术,术后自愿要求行经静脉自控镇痛(patient controlled intravenous analgesia,PCIA)的患者160例,采用随机数字表法分为4组(n=40):纳布啡40 mg组(N1组)、纳布啡60 mg组(N2组)、纳布啡80 mg组(N3组)、曲马多1 000 mg组(Q组),分别与芬太尼0.2 mg、昂丹司琼8 mg、地塞米松10 mg及生理盐水配制为100 mL镇痛泵液。比较4组患者术后6、24、48 h VAS评分、Ramsay评分、补救镇痛率及不良反应。结果术后各时间点VAS评分及补救镇痛率N1组明显高于其余3组(P<0.05),而N2、N3、Q组间差异无统计学意义(P>0.05)。N3组最高Ramsay评分及嗜睡发生率明显增高(P<0.05)。Q组术后恶心、呕吐发生率较高(P<0.05)。结论    60 mg纳布啡联合0.2 mg芬太尼PCIA用于腹腔镜下子宫肌瘤挖除术能取得满意的镇痛效果,且不良反应发生率低。

Abstract:

Objective     To investigate the analgesic effect and optimum dose of nalbuphine combined with fentanyl prepared for patient-controlled intravenous analgesia (PCIA) after laparoscopic myomectomy. Methods    One hundred and sixty patients who had arranged PCIA after laparoscopic myomectomy in our hospital between July and December 2017 were randomly divided into 4 groups (n=40): 40 mg nalbuphine group (N1), 60 mg nalbuphine group (N2), 80 mg nalbuphine group (N3) and 1 000 mg tramadol group (Q). The analgesic agents were respectively diluted with 0.2 mg fentanyl, 8 mg ondansetron and 10 mg dexamethasone together to 100 mL with normal saline for PCIA in each group. Ramsay sedation score, visual analog scale (VAS) score at 6, 24 and 48 h after surgery, ratio of those needing rescue analgesia, and adverse events were observed. Results    The VAS scores at different time points and the ratio of those needing rescue analgesia were significantly higher in the group N1 than the other 3 groups (P<0.05), but there was no significant difference among the 3 groups (P>0.05). The N3 group had the highest Ramsay sedation score and increased incidence of somnolence (P<0.05), and the Q group had higher incidences of nausea and vomiting after operation (P<0.05). Conclusion     Nalbuphine of 60 mg combined with 0.2 mg fentanyl exerts satisfactory analgesic effect and has less adverse events for PCIA after laparoscopic myomectomy.

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更新日期/Last Update: 2018-09-19