高乌甲素用于甲状腺术后镇痛

目的 观察不同剂量高乌甲素对甲状腺手术患者术后镇痛的作用.方法 60例择期行甲状腺手术的患者,ASA I～Ⅱ级.随机双盲分为3组(n=20):高乌甲素0.15 mg/kg组(L1组),高乌甲素0.20 mg/kg组(L2组)和对照组(C组),分别于手术开始前10 min静注高乌甲素0.15 mg/kg和0.20 mg/kg(用生理盐水稀释至20 mL),对照组静注生理盐水20 mL.应用视觉模拟镇痛评分(VAS)法评估各组术后2、4、6、8、12和24 h的镇痛效果,观察并记录血压、心率、脉搏氧饱和度、呼吸频率、不良反应及术后镇痛药的应用情况.结论 各组性别、年龄、体重、手术时间等比较差异无统计学意义(P>0.05).VAS评分:1组和L2组在2～24 h时VAS评分显著低于C组,差异有统计学意义(P<0.05);L2组在2、6 h时VAS评分明显低于L1组,差异有统计学意义(P<0.05).结论0.15mg/kg和0.20 mg/kg高乌甲素用于甲状腺手术患者的术后镇痛效果确切,安全可靠,后者早期镇痛效果更强.

Effect of lappaconitine for postoperative analgesia in patients undergoing thyroid surgery

Objective To compare the efficacy of different dose of lappaconitine for postoperative analgesia in patients undergoing thyroid surgery. Methods Sixty patients, belong to ASA class I or II , underwent thyroid surgery with cervical plexus block. They were divided randomly into 3 groups (n = 20) : lappaconitine 0. 15 mg/kg (group L1) , 0. 20 mg/kg (group L2) and saline control group (group C). Visual analog score (VSA) was used to evaluate the pain at 2, 4, 6, 8, 12 and 24 h after operation. BP, HR, RR, SPO_2 were recorded. Side effect and the application of postoperative analgesia were recorded. Results There was no statistical difference in sex, age, body weight and operation time (P > 0. 05). VAS scores of groups L1 and L2 were lower than those of group C at 2 ～ 24 h( P < 0. 05). VAS scores of group L2 were lower than those of group L1 at 2 h and 6 h( P <0. 05). Conclusion 0. 15 mg/ kg and 0. 20 mg/kg lappaconitine used in postoperative analgesia of thyroid surgery are safe, effective, and the latter has earlier and stronger analgesic effect.