不同PCA追加剂量对术后镇痛效果和血浆应激激素水平的影响

Observation of Postoperative Analgesia Effects by Additional Doses of the Different PCA and Research of Plasma Stress Hormone Levels

目的:观察不同剂量的高乌甲素复合小剂量吗啡用于腹部手术后硬膜外病人自控镇痛的效果、对血浆去甲肾上腺素(NE)的影响及安全性。方法:68例腹部手术患者随机分为高乌甲素高剂量组(A组)、中剂量组(B组)、低剂量组(C组)。术后进行VAS镇痛评分、Ramsay镇静评分,同时观察其毒副作用。结果:A组镇静满意率为90.9%,显著高于B组(66.7%)、C组(56.0%),相比较有显著性差异(P<0.05);三组NE水平与T1时点比较均显著上升,相比较有显著性差异(P<0.05);在T2-T5各时点,A组NE水平显著低于B、C组(P<0.05);三组不良反应发生率比较差异无统计学意义(P>0.05)。结论:使用高浓度的高乌甲素联合小剂量的吗啡可以达到较好的镇痛效果,值得临床推广应用。

Objective：To observe the effects and safety of the different doses of lappaconitine combined with low-dose morphine for postoperative PCEA in abdominal surgery and on plasma norepinephrine（NE）.Method： 68 cases of abdominal surgery were randomly divided into high-dose group（A group）,middle dose group（B group）,low-dose group（C group）.Scoring postoperative VAS pain scoring and ramsay sedation,while observing the toxic side effects.Result： The satisfaction rate of sedation in A group was 90.9%,it was significantly higher than that of the B group（66.7%） and C group（56.0%）（P 0.05）;The three groups＇ NE levels compared with the T1 time point increased significantly（P 0.05）;The A group＇s NE levels among T2-T5 time point was significantly lower than that of B and C group（P 0.05）;three groups＇ adverse reaction were no significant difference（P0.05）.Conclusion： Using hochprozentig lappaconitine combined with low-dose morphine for postoperative PCEA in abdominal surgery has good analgesic effect,it is worthy to be popularized.