论文部分内容阅读
目的:探讨羟考酮联合舒芬太尼用于剖宫产术后静脉镇痛的临床疗效.方法:选择60例行择期剖宫产术的单胎初产妇,按随机数字表法分为羟考酮联合舒芬太尼组(OS组)和舒芬太尼组(SF组).所有患者均采用腰硬联合阻滞,术后采用患者静脉自控镇痛(PCIA).镇痛泵配方:OS组为羟考酮50 mg+舒芬太尼50 μg+雷莫司琼0.3 mg,SF组为舒芬太尼100μg+雷莫司琼0.3 mg.药液均用0.9％氯化钠溶液配至100 mL,持续剂量1 mL/h,冲击剂量2 mL,锁定时间为10 min.于术后6h、12 h和24 h记录随访活动时切口疼痛评分(NRS-M)、静息时切口疼痛评分(NRS-R)、宫缩痛评分(NRS-U)、镇痛泵药物消耗量、患者满意度评分及不良反应的发生情况.结果:OS组患者在各时点的NRS-M、NRS-R、NRS-U均低于SF组,按压次数及镇痛药的消耗量也低于SF组(P＜0.05).SF组术后恶心发生率高于OS组(P＜0.05),呕吐、皮肤瘙痒、呼吸抑制、眩晕发生率两组差异无统计学意义.结论:剖宫产术后采用羟考酮联合舒芬太尼行PCIA效果优于单独使用舒芬太尼,且不增加不良反应.“,”Objective:To explore the effect of patient-controlled intravenous analgesia (PCIA) using oxycodone combined with sufentanil on cesarean section patients.Methods:Sixty elective cesarean section patients were randomly divided into two groups:SF group (sufentanil 100 μg and ramosetron 0.3 mg),OS group (sufentanil 50 μg,oxycodone 50 mg,and ramosetron 0.3 mg).All patients were received combined spinal-epidural anesthesia,and applied with PCIA after surgery.Making 0.9％ sodium chloride solution to 100 mL,continuous dosage 1 mL/h,pulse dosage 2 mL,the time was 10 min.Numerical pain scores of somatalgia at rest(NRS-R) or movment(NRS-M),numerical pain scores of uterine contraction (NRS-U),patient-controlled intravenous analgesia doses,and side effects were assessed at 6 h,12 h and 24 h after the operation.Results:At the time points of 6,12 and 24 h after surgery,the scores of NRSM,NRS-R,and NRS-U in OS group were lower than those in SF group.Times of bolus and accumulated drugs consumption in OS group were less than those in SF group (P＜0.05).The incidence of nausea in SF group was higher than that in OS group (P＜0.05).There was no significant difference in the incidences of vomiting,dizziness,pruritus or respiratory depression between the two groups.Conclusions:Oxycodone combination with sufentanil in patient-controlled intravenous analgesia may be more effective and without increasing side effects compared with sufentanil alone after cesarean section.