舒芬太尼复合小剂量纳美芬对术后静脉自控镇痛效能的作用-论文.pdf

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1、262中国中西医结合外科杂志2014年6月第20卷第3期舒芬太尼复合小剂量纳美芬对术后静脉自控镇痛效能的作用周汾，李肇端，余剑波摘要目的：观察舒芬太尼复合小剂量纳美芬用于术后静脉自控镇痛效果和对胃肠动力变化的影响。方法：选择全麻术后静脉白控镇痛患者58例，按照随机数字表法随机分为2组，对照组(舒芬太尼组)镇痛泵配方为舒芬太尼2~gCkg、氟哌利多2．5mg稀释至100mL，纳美芬组(纳美芬一舒芬太尼组)在对照组基础上加纳美芬O．5~g／kg。结果：与对照组相比，纳美芬组恶心呕吐发生率明显降低，首次

2、排气时间明显缩短

3、gesiaandGastrointestinalMotilityinPatientsthPCIAZHOUFen，LIZhao-duan，YUJian-poDepartmentofAnesthesia,TianjinNankaiHospital,Tianjin(3oowo),ChinaToobservetheeffectsofsufentanilcombinedwithultra—smalldosesofnalmefeneonpostoperativeintravenousanalgesicefec

4、tsandgastrointestinalmotilitychanges．MethodsFiflyeightpa-tientswithintravenouscontrolledanalgesia(PCIA)aftergeneralanesthesiawererandomlydividedintocontrolgroupandnalmefenegroupaccordingtorandomnumerictable，andeachgrouphad29patients．Analgesiapumpformu

5、lationsforthecontrolgroup(sufentanilgroup)wasinfusedwithsufentanil50I~g+droperidol2mg+salinedilutedto100mL．nalmefenegroup(nalmefene-sufentanilgroup)usedsufentanilplusnalmefene0．5Ixg／kgonthebasisofthecontrolgroup．VASpainscoreandadverseevents(nausea，vom

6、iting，itchingandrespiratoryde—pression)，exhausttimeforthefirsttime24hoursafteroperation,andplasmamotilinlevelweredetectedduringpostoperative48h．ResultsBothgroupsmadegoodanalgesiceffect．butnalmefenegroupwassignificantlybet—terthanthecontrolgroup．Compar

7、edwithcontrolgroup，theincidenceofnauseaandvomitinginthenalmefenegroup，wassignificantlyreduced，thetimeoffirstexhaustionwassignificantlyshortenedwithstatisticallysignifi-cantdiference<0．05)．Comparedwithpreoperation，themotilinlevelsinbothgroupswereelevat

8、ed；com—paredwithcontrolgroup，thesecretionpeakinnalmefenegroupwassignificantlydelayed．ConclusionLowdosenalmefenemayenhancetheanalgesiceffect，reducetheincidenceofpostoperativenauseaandvomitingcausedbysufentanil，aswellaspromotetherecoveryofbowelm