硫必利复合芬太尼在头颈部手术后患者自控镇痛的应用

Tiapride combined with fentanyi in patient controlled analgesia after head and neck surgery

目的对硫必利复合芬太尼用于头颈部手术后镇痛治疗的效果和安全性进行观察评价。方法选择ASAⅠ～Ⅱ级实施头颈部手术的患者50例随机分为2组,硫必利芬太尼复合(TF)组和芬太尼(F)组,每组各25例。TF组:硫必利600 mg+芬太尼0.6 mg;F组:芬太尼1.2 mg。两组均以生理盐水配制到100 ml。首次量5ml,背景输入量2 ml/h,单次PCA量0.5ml,锁定时间为15 min。记录术后4、8、24、48 h的患者疼痛评分、有效按压次数和不良反应。结果两组患者术后镇痛满意度和术后4、8、24、48 h的VAS评分、有效按压次数的差异无统计学意义(P>0.05),TF组的恶心呕吐、嗜睡和尿潴留等不良反应发生率分别为8%、4%和16%,低于F组的36%、24%和44%(P<0.05)。结论硫必利复合芬太尼应用于头颈部手术后镇痛治疗效果满意,与单纯芬太尼相当,但不良反应发生率低,是一种安全有效的镇痛方法。

Objective To evaluate the efficiency and safety of the combination use of tiapride and fentanyl for patient-controlled analgesia after head and/or neck surgery. Methods Fifty ASA Ⅰ-Ⅱ patients undergoing head and/or neck surgery were randomly divided into two groups and each group included 25 patients： one group for combination use of tiapride and fentanyl （group TF） and the other for use of fentanyl only （group F）. The patients were given tiapride 600 mg ＋ fentanyl 0. 6 mg in group TF and fentanyl 1.2 mg in group F,which were diluted to 100 ml in normal saline solution in both group. The first dosage was 5 ml, the background dosage 2 ml/h,single PCA dosage O. 5 ml and the lock-time 15 min. The visual analogue scale （VAS） ,available press times and the rate of side-effects were assessed at 4,8,24 and 48 hours post- surgery. Results There were no significant differences for patients＇ satisfaction, VAS at 4,8,24 and 48 hours post-surgery and available press times between two groups （ P 〉0.05 ）. However, the rates of sideeffects such as nausea and vomiting,somnolence,and urinary retention were significantly lower in group TF （8% ,4% and 16% ,respectively） than that in group F （36% ,24% and 44% ,respectively） （P〈0. 05 ）. Conchmion Whereas the analgesia efficacy of the combination use of tiapride and fentanyl is the same as use of fentanyl alone after head and/or neck surgery,the rate of side-effects is lower in group TF.