静脉镇痛泵中芬太尼按体重公式配置的可行性

Feasibility of intravenous analgesia with fentanyl in the dose calculated by body weight formula

目的探讨术后芬太尼静脉镇痛剂量按体重公式配置的可行性。方法椎管内麻醉下行子宫切除术患者100例,随机均分为观察组和对照组。观察组静脉镇痛泵中芬太尼按公式配置,并于稳态血药浓度时抽血,通过气相色谱质谱仪(GC-MS)测定芬太尼血药浓度;对照组静脉镇痛泵中芬太尼按20μg/kg配置。以视觉模拟评分(VAS)评估疼痛程度,观察镇痛效果及不良反应。结果观察组芬太尼血药浓度0.2～1.5ng/ml,在安全范围内。观察组VAS显著低于对照组(2.34±1.92vs5.16±2.30)(P<0.01)。结论在静脉镇痛泵中芬太尼按公式配置,提前给负荷量后,静脉恒速输注镇痛,更符合个体化镇痛。

Objective To study the feasibility of fentanyl dose of intravenous analgesia pump by body weight formula calculation. Methods A hundred hysterectomy cases of intrathecal anesthesia were divided into experiment group and control group. Fentanyl dose of intravenous analgesia pump of experimental group was calculated by body weight formula. In experimental group, the blood samples were collected when plateau concentration of the drup was stable for the measurement of fentanyl by gas chromatography. In control group , fentanyl of intravenous analgesia was pumped prepared according to 20 μg/kg. Visual analogue scales （VAS） was used to evaluate the analgesic effect. Results Fentanyl plateau concentration was 0.2-1.5 ng/ml, which is in the safety margin. VAS was significantly lower in experiment group than that in control group （2.34±1.92 vs 5. 16±2.30）（P〈 0.01）. Conclusion Calculating fentanyl dose of intravenous analgesia pump by formula, giving loading dose in advance and giving medicine at constant speed are more suitable for individualized pain rekief .