高乌甲素用于甲状腺术后镇痛的临床观察

摘要

目的：观察不同剂量高乌甲素对甲状腺手术患者术后镇痛的作用。方法将60例择期行甲状腺手术的患者，ASAⅠ～Ⅱ级，随机双盲分为3组（ n＝20）：高乌甲素0.15 mg／kg组（ L1组），高乌甲素0.20 mg／kg组（ L2组）和对照组（ C组），分别于手术开始前给予高乌甲素0.15 mg／kg或0.20 mg／kg （用生理盐水稀释至20 mL），对照组给予生理盐水20 mL。应用视觉模拟镇痛评分（ VAS）法评估各组术后2 h、4 h、6 h、8 h、12 h和24 h的镇痛效果，观察并记录血压、心率、脉搏氧饱和度、呼吸频率、不良反应及术后止痛药的应用情况。结果各组性别、年龄、体重、手术时间、不良反应及术后用药等比较差异无统计学意义（ P＞0.05）。 VAS评分：与C组相比，L1组和L2组在2～24 h时镇痛效果好，VAS评分低于C组，差异有统计学意义（ P＜0.05）；L1组与L2组相比，在2 h、6 h时L2组低于L1组，差异有统计学意义（ P＜0.05）。结论高乌甲素用于甲状腺手术患者的术后镇痛效果确切，安全可靠，后者早期镇痛效果更强。%Objective To compare the efficacy of different doses of lappaconite hydrobromide for postoperative analgesia in patients un-dergoing thyroid surgery.Methods 60 patients under thyroid surgery were divided into three groups:lappaconite hydrobromide 0.15 mg/kg (group L1), 0.20 mg/kg (group L2) diluted to 20ml before operation, and the control group(group C).Pain intensity was measured using VAS scores at the 2, 4, 6, 8, 12 and 24 hours after operation.The adverse reaction and the number of patients asking for analgesics were recorded.Results Demographic data including sex, age, body weight and operation time were similar among the three groups.There were significant differences of VAS scores in group L1 and group L2 at 2~24 h compared with group C.VAS scores in group L2 were lower than group L1 at 2 h and 6 h, with stastical difference( P<0.05).Conclusion Lappaconitine for patients with postoperative analgesic effect do thyroid surgery all safe and reliable, and in the latter early stage, patients have stronger analgesic effect.