氟哌啶与枢复宁减少术后PCA恶心呕吐的临床观察

来源 :中国疼痛医学杂志 | 被引量 : 0次 | 上传用户:wenyuanyuan0929
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80例全麻下择期手术的病人,随机、双盲分为四组,PCA用药均为吗啡(2mg/ml)。Ⅰ组为对照组;Ⅱ组为吗啡药液中加入小剂量氟哌啶(0.05mg/ml);Ⅲ组为吗啡药液中加入大剂量氟哌啶(0.125mg/ml);Ⅳ组在麻醉诱导时静注枢复宁4mg。记录术后4、8、12、24、48h吗啡用量、疼痛评分、恶心、呕吐、镇静评分。枢复宁组(Ⅳ组)病人恶心和呕吐发生率由77.7%和50%(对照组)分别降低至40%和20%,差别有显著性(P<0.05);氟哌啶组(Ⅱ组及Ⅲ组)病人恶心和呕吐发生率虽然分别降低至55%和35%、42.1%和21.1%,但无统计学意义(P>0.05)。氟哌啶组病人术后12小时的镇静评分明显高于对照组(P<0.01)。各组间疼痛、VAS评分及吗啡用量无差别(P>0.05)。结果提示静脉注射枢复宁能有效地减少术后PCA治疗中的恶心呕吐,效果优于氟哌啶。 Eighty patients undergoing elective surgery under general anesthesia were randomized, double-blindly divided into four groups, and PCA medication was morphine (2 mg / ml). Group Ⅰ was the control group; Group Ⅱ was morphine plus low dose of haloperidol (0.05mg / ml); Group Ⅲ was morphine plus high dose of haloperidol (0.125mg / ml); Group Ⅳ Induction of anesthesia induced by intravenous rehabilitation 4mg. The amount of morphine, pain score, nausea, vomiting and sedation scores were recorded at 4, 8, 12, 24, and 48 h postoperatively. The incidence of nausea and vomiting in patients treated with Shenfu Ning (group Ⅳ) decreased from 77.7% and 50% (control group) to 40% and 20%, respectively, with a significant difference (P <0.05) The incidence of nausea and vomiting in patients in group Ⅱ (group Ⅱ and group Ⅲ) was reduced to 55%, 35%, 42.1% and 21.1%, respectively, but no statistical significance (P> 0.05). Haloperidin patients sedation score 12 hours after surgery was significantly higher than the control group (P <0.01). There was no difference in pain, VAS score and morphine dosage between groups (P> 0.05). The results suggest that intravenous injection of Fufang Ning can effectively reduce postoperative PCA treatment of nausea and vomiting, the effect is superior to haloperidol.
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