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1、不同剂量瑞芬人尼用于术后PCIA的临床对比研究【摘要】丨1的对比观察不同剂塑瑞芬太尼(REM)JIJ于术后PCIA效果及不良反应的发生率。方法全身麻醉下择期手术成年患者120例行PCIA,按REM川药剂量不同，随机分成4组(n=30)：I组0.0033ug/(kg・min)・l,I纽0.005ug/(kg・11曲)・1,111纟110.0067ug/(kg*min)-l,IV组0.0083ug/(kg*min)-k于术后6、12、24h各评定一次BP、HR、R、SpO2。镇痛治疗后6h用视觉模拟评分法(VAS)判断患者白诉切口疼痛强度。观察镇痛期间恶
2、心、呕吐、皮肤瘙痒、嗜睡等不良反应及症状程度。结果患者术后6、12、24hBP、HR、R及SpO2与术前比较差异无显著性；III组、IV组与I组、II组的镇痛效果差异有高度显著性(P均<0.01)；IV组的不良反应发牛率与其它三组比较差异有高度显著性(P均<0.01)o结论0.0067Ug/(kgmin)・lREM行术后PCIA能取得良好的术后镇痛效果，不良反应发牛少,更适合PCIAo【关键词】外科手术；疼痛，手术后；瑞芬太尼；病人；静脉自控镇痛Acomparisonofdifferentdosageofremifentanilinpatient-c
3、ontrolledintravenousanalgesiaforpostoperativepainWEIKe,HUANGZe-han,WEILong-hua,WURi-qian,LIMing-liang,HUANGJin-feng,DENGJun(DepartmentofAnesthesia,AffiliatedHospitalofYoujiangMedicalCollegeforNationalities,Baise,Guangxi533000,P.R.China)Abstract：ObjectiveToevaluatetheefficacyofd
4、ifferentdosageofremifentanil(REM)inpatient-controlledintravenousanalgesia(PCIA)forpostoperativepainandobservethesidereactionsinordertoprovidebasisofdrugelectionduringPCIA・MethodsAccordingtodifferentdosageofREM,120patientsreceivingPCIAafterelectiveoperationwithgeneralanesthesiaw
5、ererandomlyallocatedtofourgroups(n=30foreach)：groupI0.0033μg/(kg.min)-l,groupII0.005μg/(kg.min)・l,groupIII0.0067μg/(kg.min)・l,groupIV0.0083μg/(kg.min)-1.6h,12hand24hafteroperation,thelevelsofBP,HR,RandSpO2weredetectedforeachtime.6hoursafteranalgesia,thevisualanalogu
6、escales(VAS)wereusedtoassaythepaindegree.Recordingadversereactionsuchasnausea,vomiting,itchofskin,drowsinessandtheirdegrees.Results6h,12hand24hafteroperation,BP,HR,RandSpO2werethesameasthosebeforeoperation,therewerenostatisticaldifferences.IngroupsIIIandIV,theefficacyofanalgesi
7、awerebetterthanthatingroupsIandII,therewerestatisticallysignificantdifferences(P<0.01)；thesidereactionoccurredingroupIVmoresignificantlyincomparisontootherthreegroups(P<0.01).ConclusionREM0.0067μg/(kg.min)-lcangetbetteranalgesiaresultsforPCIA,andhaslesssideeffectsaswell.Keyw
8、ords:surgicalprocedures,operative；pain,postoperative；r
