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1、喷他佐辛应用于神经外科开颅手术术后镇痛效果观察［摘要］目的：随机双盲对比观察不同剂量的喷他佐辛用于颅脑术后的镇痛效果及不良反应。方法：择期全麻颅脑手术患者90例（ASAI〜II）,将其随机分为喷他佐辛90mg组（I组，n=30）.120mg组（II组，n=30）和150mg组（III组，n二30）。术中吸入七氟烷行全身麻醉。根据分组向患者自控镇痛泵（PCA）中注入喷他佐辛，并均以生理盐水稀释到100ml,设置背景剂量1.5ml/h,单次剂量0.5ml,间隔时间15mino术中缝硬膜时接上电子镇痛泵实行静脉自控镇痛（patientcontroliedintravenous
2、analgesia,PCIA）。记录术后清醒时、4h、16〜20h、24h、40〜44h、48h、64〜68h、72h的平均动脉压（MAP）、心率（HR）、呼吸（R）、血氧饱和度（Sp02）、VAS评分、疼痛部位、疼痛性质、PCA累积总量、PCA按压用量、累计按压次数及累计有效按压次数，观察恶心、呕吐、皮肤瘙痒、呼吸抑制、颜面水肿及球结膜水肿的发生情况。结果：II、III组患者的PCIA按压次数、有效按压次数明显低于I组（P<0.05）。II、III组患者术后24h内补救用药的使用例数明显少于I组（PV0.05）。结论：颅脑术后3d内采用PCA持续泵注喷他佐辛120mg
3、（平均用量1.79mg/h）和150mg（平均用量2.25mg/h）均能到达满意的术后镇痛效果，而前者的量效比更为合理。［关键词］喷他佐辛；颅脑手术；静脉自控镇痛；视觉模拟评分法［中图分类号］R619［文献标识码］A［文章编号］1673-7210(2012)01(a)-083-03ObservationoftheanalgesiceffectofPentazocineaftercraniotomyLIUChaol,2,XUJinl,WANGBaoguol,2*,HUANGZheng2,WANGShuangyan21.DepartmentofAnesthesiology,
4、BeijngTiantanHospitalAffiliatedtoCapitalMedicalUniversity,Beijing100050,China；2.DepartmentofAnesthesiology,the11thClinicalHospitalofCapitalMedicalUniversity/BeijingSanboBrainHospital,Beijing100093,China［Abstract］Objective：ToinvestigatetheefficacyofanalgesiaandadverseeffectsofPentazocinew
5、ithdifferentdosesaftercraniotomy.Methods：90neurosurgicalpatientsrequiringselectiveoperationwithgeneralanesthesis(ASAphysicalI-II)wererandomlyallocatedintoPentazocine90mggroup(groupI,n=30),120mggroup(groupII,n=30)and150mggroup(groupIII,n=30)・PatientsweretakenSevofluranetoperformgeneralane
6、sthesisduringintraoperation.Accordingtothesectionalization,Pentazocinewasinjectedintopatientcontrolledanalgesia(PCA)ofpatients,whichwasdilutedinto100mlwithnormalsaline・Thebasalinfusionwas1.5ml/h,singledosewas0.5ml,spacingintervalwas15min.Whensewingtheduramaterduringtheoperation,electroni
7、canalgesicpumpwasusedtoperformpatientcontrolledintravenousanalgesia(PCIA).TheMAP,HR,R,Sp02,VASscores,achespot,achefeature,amountsofPCA,pressdosage,totaltimesofpressandeffectivetimesofpresswererecordedwhenthepatientswereawakeandin4h,16-20h,24h,40-44h,48h,64-68h,72hafterthe
