芬太尼用于妇产科术后镇痛效果临床观察

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1、芬太尼用于妇产科术后镇痛效果临床观察【中图分类号】R719.3+1【文献标识码】A【文章编号】1672-6383-（2010）12-0075-01【摘要】目的：观察芬太尼用于妇产科术后镇痛效果。方法：200例妇产科病人，ASA分级I〜II级，年龄22〜60岁，其中子宫全切术50例；附件切除术40例；剖宫产术110例。术中采用腰硬联合麻醉，穿刺间隙为L2〜L3、L3〜L4,术中麻醉效果满意，手术顺利，术后将受术者采用双盲法分为两组，自控硬膜外镇痛PCEA组100例（术后保留硬膜外导管），肌肉注射组100例，注射强痛定、哌替唳等止痛药物（术后拔除硬

2、膜外导管）。PCEA组100ml药液中含芬太尼0.5mg,甲磺酸罗哌卡因357.6mg.枢丹8mg。负荷剂量：首次用药5ml,持续剂量加1/h,按键锁定时间0.5ml/15min,即15min内按压启动键仅一次有效，病人可根据疼痛情况按压一次有效剂量。镇痛时间为48h,观察术后6h、12h、24h、48h两组间镇痛效果。结果：两组病人术后48h内呼吸、循环无明显变化。恶心、呕吐PCEA组低于肌肉注射组。VAS评分：PCEA组低于肌肉注射组，PCEA组镇痛效果最佳。结论:采用PCEA方法由病人参与自控镇痛，能有效的控制术后疼痛，血压、心率平稳，能

3、较好的改善呼吸功能，可用力咳嗽,正确有效的呼吸，预防呼吸道感染，减少肺部并发症，促进刀口愈合，使病人早日康复。我院在芬太尼应用于术后镇痛取得了满意效果。【关键词】芬太尼；术后阵痛；PCEAFentanylforpostoperativeanalgesiaingynecologyandobstetricsclinicalobservationGuoLiang[Abstract】Objective：Toobservetheanalgesiceffectoffentanylforobstetricsandgynecology.Methods:200c

4、asesofobstetricandgynecologicalpatients,ASAgradeI-II,aged22〜60years,ofwhich50casesofhysterectomy；Annex40casesofresection；110casesofcesareansection.Intraoperativeuseofepiduralanesthesia,puncturegapL2〜L3,L3〜L4，anestheticeffectsofsatisfaction,thesuccessfuloperationandpostoperat

5、ivepatientswhowillbedividedintotwogroupsbydouble-blind,controlledepiduralanalgesia.PCEA100patients(epiduralcatheterafterreservation),intramuscularinjectionof100patients,injectionofstrongpainsetting,pethidineandotheranalgesics(afterremovalofepiduralcatheter).100mlliquidintheP

6、CEAgroupwithfentanyl0.5mg,ropivacainemesylate357.6mg,Ondansetron8mg・Loadingdose：thefirstdrug5ml,continuousdoseof2ml/h,keypadlocktime0.5ml/15min,pressthestartbuttonis15min,onetimeonly,thepatientcanpressaneffectivedoseofpainconditions.Analgesiatimewas48h,observedafter6h,12h,24

7、h,48hanalgesiceffectbetweenthetwogroups.Twogroupsofpatientswithin48haftertheresultsofrespiratory,circulatorynosignificantchange・Nausea，vomitingPCEAgroupthaninintramusculargroup.VASscore：PCEAgroupwaslowerthanintramuscularinjectiongroup,PCEAgroupthebestanalgesiceffect.Conclusi

8、onPCEAparticipationbythepatient-controlledanalgesiamethodcaneffectivelycont