舒芬太尼复合氯诺昔康在全麻患者术后镇痛中的应用

摘要

目的：探讨舒芬太尼复合氯诺昔康用于全身麻醉(全麻)患者术后自控静脉镇痛(PCIA)的效果和不良反应。方法选择择期全身麻醉下行腹部手术的患者90例，随机分为A组(氯诺昔康)、B组(舒芬太尼)和C组(舒芬太尼+氯诺昔康)，每组30例。患者清醒拔管后进行PCIA。记录患者48 h内的心率(HR)、平均动脉压(MAP)和脉搏氧饱和度(SpO2)变化情况、术后镇痛、镇静评分以及并发症的发生情况。结果在4、8、12、24 h 4个监测点B、C组患者的VAS评分显著低于A组(P<0.05)。B组患者出现恶心呕吐、呼吸抑制的发生率显著高于A组和C组(P<0.05)。结论较单纯使用舒芬太尼和氯诺昔康镇痛相比，舒芬太尼复合氯诺昔康用于术后镇痛患者的满意度高，不良反应少，可安全用于临床。%Objective To investigate the effect and adverse reactions of sufentanil combined with lornoxicam applied in patient controlled intravenous analgesia (PCIA) for general anesthesia patients. Methods A total of 90 general anesthesia patients for abdominal operation were selected, and they were divided into group A (lornoxicam), group B (sufentanil), and group C (sufentanil+lornoxicam), and each group contained 30 cases. PCIA was implemented after clear extubation for patients. Records were made on changes of heart rate (HR), mean arterial pressure (MAP), oxyhemoglobin saturation (SpO2) within 48 h, postoperative analgesia, sedation score, and complications of patients. Results At four detection points as 4, 8, 12, and 24 h, the group B and group C had obviously lower VAS scores than the group A (P<0.05). The group B had significantly higher incidences of nausea, vomiting, and respiratory depression than group A and group C (P<0.05). Conclusion Compared with single implement of sufentanil or lornoxicam for analgesia, the combination of sufentanil and lornoxicam can provide high satisfaction in postoperative analgesia with few adverse reactions. It is safe for clinical application.