芬太尼联合氟哌利多用于剖宫产术后静脉镇痛效果观察

摘要

目的：探讨芬太尼联合氟哌利多用于剖宫产术后患者自控静脉镇痛（Patient-controlled intravenous analgesia ， PCIA）的效果及对术后恶心、呕吐（Postoperative nausea and vomit ，PONV）不良反应的影响。方法：60例持续硬膜外麻醉下剖宫产术后患者，随机分为观察组和对照组，每组30例，对照组：芬太尼1mg＋生理盐水80ml；观察组：芬太尼1mg＋氟哌利多2．5mg＋生理盐水80ml ，分别予自控镇痛泵持续静脉自控泵注2ml/h ，观察镇痛、镇静效果及恶心、呕吐不良反应发生率。结果：两组Prince-Henry疼痛评分，在术后1h、2h、4h及8h时间点上，差异无显著性（ P＞0．05）。术后16h观察组明显低于对照组，差异有显著性（P＜0．01）。术后24h及48h ，观察组低于对照组，差异具有显著性（P＜0．05）；镇静评分，组间比较无显著性差异（P＞0．05）；恶心、呕吐不良反应上，观察组恶心、呕吐发生率明显低于对照组，差异具有统计学意义（P＜0．01）。结论：芬太尼联合氟哌利多用于剖宫产术后自控静脉镇痛效果明显优于单独应用芬太尼，且能有效控制恶心、呕吐等并发症的发生。%Objective:To analyse the effect of postoperative pain relief for patient-controlled intravenous analgesia (PCIA) after cesarean section and the influence of postoperative nausea and vomit (PONV) by infusing fentanyl com-bined with droperidol .Methods:60 patients who underwent cesarean section under epidural anesthesia were randomly divided into 2 groups ,with 30 cases in each group .The patients in control group were given fentanyl 1mg with NS 80ml ,the observe group were given fentanyl 1mg ,droperidol 5mg with NS 80ml .The two groups were infusing contin-uously at rate of 2ml/h to observe the effect of sedation and analgesia ,and incidence of postoperative nausea and vomit (PONV) .Results:Prince-Henry pain score:there’s no obvious difference at 1 ,2 ,4 and 8h postoperatively between the two groups(P>0 .05) .The observe group has significantly lower score than the control group at 16h postoperatively(P<0 .01) .The score is decreased apparently in observe group compared with control group at 24h or 48h postoperatively (P<0 .05);sedation score:there is no significant difference between the two groups(P>0 .05);complication of nausea and vomit :the incidence of PONV in observe group is apparently lower than that in control group(P<0 .01) .Conclu-sion:Infusing fentanyl combined with droperidol has better effect than infusing fentanyl separately to relieve postopera-tive pain for PCIA after cesarean section ,and can effectively reduce the incidence of PONA .