芬太尼透皮贴剂用于烧伤切痂植皮术后镇痛的效果观察

[目的]探讨芬太尼透皮贴剂用于烧伤切痂植皮术后镇痛的临床效果及不良反应。[方法]将80例Ⅱ度～Ⅲ度烧伤切痂植皮面积(10±3)%的病人随机分为芬太尼透皮贴剂组(A组)和安慰贴剂组(B组)各40例。A组病人术前2h给予芬太尼透皮贴剂镇痛;B组病人术前2h予贴1片邦迪创可贴作安慰剂,不用预防性镇痛药,仅在术后出现疼痛时再予处理。[结果]手术后2h、4h、8h、16h、24h、48h、72h各时间点的视觉模拟评分(VAS),A组显著低于B组(P<0.01);术毕、术后第1天血糖值A组显著低于B组(P<0.01);A组恶心、呕吐、嗜睡发生率显著高于B组(P<0.05),头晕、便秘、皮肤瘙痒、尿潴留发生率,两组差异无统计学意义(P>0.05);两组均未发现呼吸抑制及呼吸困难。[结论]25μg/h芬太尼透皮贴剂应用于烧伤切痂植皮术后能达到有效镇痛。

Observation on postoperative analgesia effect of Fentanyl Transdermal patch used in burn escharectomy skin grafting

Objective. To probe into the clinical effect and adverse reactions of Fentanyl Transdermal patch used in burn escharectomy skin grafting for postoperative analgesia. Methods. A total of 80Ⅱ～Ⅲ degree burned patients whose areas of skin grafting were （10±3）% were selected and randomly divided into two groups （Fentanyl Transdermal System group （A group） and Comfort patch group （B group） ,40 cases in each. A group patients were given Fentanyl Transderrnal patch for analgesia at 2 h before the operation. Group B patients were posted with a Bondi creators for placebo at 2 h before operation, no preventive analgesia, only with the re -processing on postoperative pain. Results. VAS scores of A group patients in each time points were significant lower than that of B group after operation （P〈0.01） and blood glucose was also lower than that of B group at the end of surgery and on postoperative first day （P〈0.01）. The incidences of adverse reactions including nausea, vomiting and drowsiness were much higher than that of control group （P〈0.05）. But the incidence of dizziness,constipation, itch of skin and urinary retention were the same to B group （P〉0. 05）. There was no respiratory depression and difficulty in breathing occurred in both groups. Conclusion：The Fentanyl Transdermal patch applied can achieve the effective analgesia after escharectomy and skin grafting.