芬太尼静滴用于术后镇痛的可行性观察

Feasibility study of vein-instillation of fentanyl to postoprative analgesia

目的探讨芬太尼静滴用于术后镇痛的可行性。方法全麻下腹部手术的患者120例(A SAⅠ级),随机双盲分为3组各40例。F 2组术后肌注芬太尼2μg/kg;F 4组术后先给芬太尼2μg/kg肌注,之后给4μg/kg静滴;M组术后给哌替啶1m g/kg肌注。采用P rince-H enry(PH)疼痛程度评分法、警觉/镇静(OAA/S)评分法和自拟全身炎症反应综合征(S IRS)评分法评估术后8h(T 0)、16h(T 1)、24h(T 2)和48h(T 3)的镇痛镇静效果及病情变化。48h后采用视觉模拟疼痛评分(VA S)评估整体镇痛效果,了解患者对术后镇痛的满意度、镇痛药物并发症及总用量。结果PH、OAA/S与S IRS评分均以F 4组最理想,与F 2、M组比较均有极显著性差异(P均<0.01);F 2组PH、OAA/S评分稍高于M组,F 2、F 4组S IRS评分显著低于M组(P<0.01)。48h后VA S评分、并发症、患者满意度仍以F 4组最优。结论术后芬太尼静滴镇痛效果好,安全性高,且有助于防治S IRS。

Objective： To study the feasibility of vein-instillation of fentanyl to postoprative analgesia. Methods： 120 cases who suffered from an operation were divided into three groups, 40 cases in each group. Fentanyl were used 2μg/kg through intramuscular injection in group F2 and 4μg/kg through vein-instillation after the first step in group F4, pethidine were intramuscular injection 1mg/kg in group M. Each cases＇s scores on PH and OAA/S and SIRS were recorded at 8h, 16h, 24h, 48h postoprative. The VAS method were ued to analyse the whole analgesia effect and the patients feeling and complicationsut 48h postoprative. Results：The group F4 had the most high scores ,the group F2 had higher scores in PH and OAA/S,the SIRS scores was lower in groups F2 and F4 than in group M. Conclusion ：It＇s more effect and more safe and also benefit to prevent and cure SIRS that fentanyl is used through vein-instillation to postoprative analgesia.