不同浓度舒芬太尼复合氟哌啶用于乳腺手术后静脉自控镇痛的观察

目的观察不同浓度的舒芬太尼复合氟哌啶应用于乳腺手术病人术后静脉自控镇痛(PCIA)的疗效,探讨舒芬太尼PCIA的安全有效浓度。方法选择择期行乳腺手术病人90例,随机分为3组,每组30例。S1组:1.0μg/ml舒芬太尼+50μg/ml氟哌啶;S2组:1.2μg/ml舒芬太尼+50μg/ml氟哌啶;S3组:1.5μg/ml舒芬太尼+50μg/ml氟哌啶。PCA给药模式设置:总量100ml,背景输注2ml/h,PCA2ml,锁定时间30min。观察术后4、8、12、24、48h各时间点的镇痛效果(VAS评分)和不良反应。结果S1组镇痛效果较另两组差(p<0.05或p<0.01),S2、S3组相当(p>0.05);镇静、恶心呕吐发生率S1、S2组低于S3组(p<0.01)。结论1.2μg/ml舒芬太尼为合适镇痛浓度,复合氟哌啶可安全有效地用于乳腺手术术后PCIA的镇痛治疗。

COMPARATIVE EFFECTS OF DIFFERENT CONCENTRATIONS OF SULFENTANIL COMBINED WITH DROPERIDOL IN PATIENT CONTROLLED INTRAVENOUS ANALGESIA IN BREAST SURGERY

Objective To observe the effects of sulfentanil combined with droperidol in patients controlled intravenous an algesia （PCIA）. After breast operation, determine the best concentration of sulfentanil. Methods Ninety patients after breast operation were randomly divided into three groups with 30 cases each. The patients in group S1 received 1.0 μg/ml sulfentanil plus 50 μg/ml droperidol. In group S2, 1.2 μg/ml sulfentanil plus 50 μg/ ml droperidol. In group S3, 1.5 μg/ml sulfentanil plus 50 μg/ml droperidol. PCIA parameters were a bolus dose of 2 ml, lock out interval of 30 minutes and continuous infusion of 2 ml/h. Visual analogue scales （VAS） and adverse effects were observed at 4, 8, 12., 24 and 48 h postoperatively. Results Pain score was higher in group S1 than that in group S2 and group S3（p 〈0.05 or 0.01 ）. There was no significant difference between group S2 and group S3. Sedation score and the incidence of adverse effects such as nausea and vomiting were lower in group S1 and group S2 than that in group S3（p 〈0.01 ）. Conclusion PCIA with 1.2 μg/ml sulfentanil combined with droperidol can provide a good postoperative analgesia and use safely in spinal surgical patients.